Browsing by Author "Rahimi, Bilal Ahmad"

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    Infectious causes of fever of unknown origin in developing countries: An international ID-IRI study
    (Elsevier, 2023-09-28) Erdem, Hakan; Al-Tawfiq, Jaffar A.; Abid, Maha; Yahia, Wissal Ben; Akafity, George; Ramadan, Manar Ezzelarab; Amer, Fatma; El-Kholy, Amani; Hakamifard, Atousa; Rahimi, Bilal Ahmad; Dayyab, Farouq; Caskurlu, Hulya; Khedr, Reham; Tahir, Muhammad; Zambrano, Lysien; Khan, Mumtaz Ali; Raza, Aun; El-Sayed, Nagwa Mostafa; Baymakova, Magdalena; Yalci, Aysun; Cag, Yasemin; Elbahr, Umran; Ikram, Aamer; Medicine, School of Medicine
    Background: Fever of unknown origin (FUO) in developing countries is an important dilemma and further research is needed to elucidate the infectious causes of FUO. Methods: A multi-center study for infectious causes of FUO in lower middle-income countries (LMIC) and low-income countries (LIC) was conducted between January 1, 2018 and January 1, 2023. In total, 15 participating centers from seven different countries provided the data, which were collected through the Infectious Diseases-International Research Initiative platform. Only adult patients with confirmed infection as the cause of FUO were included in the study. The severity parameters were quick Sequential Organ Failure Assessment (qSOFA) ≥2, intensive care unit (ICU) admission, vasopressor use, and invasive mechanical ventilation (IMV). Results: A total of 160 patients with infectious FUO were included in the study. Overall, 148 (92.5%) patients had community-acquired infections and 12 (7.5%) had hospital-acquired infections. The most common infectious syndromes were tuberculosis (TB) (n=27, 16.9%), infective endocarditis (n=25, 15.6%), malaria (n=21, 13.1%), brucellosis (n=15, 9.4%), and typhoid fever (n=9, 5.6%). Plasmodium falciparum, Mycobacterium tuberculosis, Brucellae, Staphylococcus aureus, Salmonella typhi, and Rickettsiae were the leading infectious agents in this study. A total of 56 (35.0%) cases had invasive procedures for diagnosis. The mean qSOFA score was 0.76±0.94 {median (interquartile range [IQR]): 0 (0-1)}. ICU admission (n=26, 16.2%), vasopressor use (n=14, 8.8%), and IMV (n=10, 6.3%) were not rare. Overall, 38 (23.8%) patients had at least one of the severity parameters. The mortality rate was 15 (9.4%), and the mortality was attributable to the infection causing FUO in 12 (7.5%) patients. Conclusions: In LMIC and LIC, tuberculosis and cardiac infections were the most severe and the leading infections causing FUO.
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    Mortality Associated with Surgical Site Infections Following Cardiac Surgery: Insights from the International ID-IRI Study
    (Elsevier, 2025-01-08) Erdem, Hakan; Ankarali, Handan; Al-Tawfiq, Jaffar A.; Angamuthu, Kumar; Piljic, Dragan; Umihanic, Ajdin; Dayyab, Farouq; Karamanlioğlu, Dilek; Pekok, Abdullah Umut; Cagla-Sonmezer, Meliha; El-Kholy, Amani; Gad, Maha Ali; Velicki, Lazar; Akyildiz, Ozay; Altindis, Mustafa; Başkol-Elik, Dilşah; Erturk-Sengel, Buket; Kara, İbrahim; Kahraman, Umit; Özdemir, Mehmet; Caskurlu, Hulya; Cag, Yasemin; Al-Khalifa, Abdulwahab; Hakamifard, Atousa; Batinjan, Marina Kljaković-Gašpić; Tahir, Muhammad; Tukenmez-Tigen, Elif; Zajkowska, Joanna; ElKholy, Jehan; Gašparović, Hrvoje; Filiz, Mine; Gul, Ozlem; Tehrani, Hamed Azhdari; Doyuk-Kartal, Elif; Aybar-Bilir, Yesim; Kahraman, Hasip; Mikulić, Hrvoje; Dayan, Saim; Cascio, Antonio; Yurdakul, Eray Serdar; Colkesen, Fatma; Karahangil, Kadriye; Espinosa, Angel; Rahimi, Bilal Ahmad; Vangel, Zdraveski; Fasciana, Teresa; Giammanco, Anna; Medicine, School of Medicine
    Objectives: Surgical site infections (SSIs) after cardiac surgery increase morbidity and mortality rates. This multicenter study aimed to identify mortality risk factors associated with SSIs after heart surgery. Methods: Conducted from January to March 2023, this prospective study included 167 patients aged >16 years with post-heart surgery SSIs. The primary focus was the 30-day mortality. Univariate analysis and multivariate logistic regression utilizing the backward elimination method were used to establish the final model. Results: Several factors significantly correlated with mortality. These included urinary catheterization (odds ratio [OR] 14.197; 90% confidence interval [CI] 12.198-91.721]), emergent surgery (OR 8.470 [90% CI 2.028-35.379]), valvular replacement (OR 4.487 [90% CI 1.001-20.627]), higher quick Sequential Organ Failure Assessment scores (OR 3.147 [90% CI 1.450-6.827]), advanced age (OR 1.075 [90% CI 1.020-1.132]), and postoperative re-interventions within 30 days after SSI (OR 14.832 [90% CI 2.684-81.972]). No pathogens were isolated from the wound cultures of 53 (31.7%) patients. A total of 43.1% of SSIs (n = 72) were due to gram-positive microorganisms, whereas 27.5% of cases (n = 46) involved gram-negatives. Among the gram-positive bacteria, Staphylococci (n = 30, 17.9%) were the predominant microorganisms, whereas Klebsiella (n = 16, 9.6%), Escherichia coli (n = 9, 5.4%), and Pseudomonas aeruginosa (n = 7, 4.2%) were the most prevalent. Conclusions: To mitigate mortality after heart surgery, stringent infection control measures and effective surgical antisepsis are crucial, particularly, in the elderly. The clinical progression of the disease is reflected by the quick Sequential Organ Failure Assessment score and patient re-intervention, and effective treatment is another essential component of SSI management.