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    Clonal outbreak of Myroides odoratimimus in ICU patients: A descriptive analysis of pan-drug resistance and associated mortality
    (Elsevier Science Inc, 2025) Karvar, Sinasi; Okumus, Elif; Tutan, Kubra Nur; Yesilyurt, Aysun Ozel
    Myroides odoratimimus, a non-fermentative Gram-negative bacillus, has increasingly been recognized as a cause of opportunistic healthcare-associated infections, particularly in intensive care units (ICUs). Its intrinsic resistance to multiple antibiotic classes, including carbapenems, aminoglycosides, and polymyxins, presents serious therapeutic challenges. Here, we report a clonal outbreak of urinary M. odoratimimus involving 27 patients over a 7-month period in a tertiary care hospital in Turkey. All patients were hospitalized in ICUs and had indwelling urinary catheters. The isolates were identified using automated systems and confirmed through 16S rRNA gene sequencing. Clonal relatedness was determined by (GTG)5-PCR, demonstrating genetic identity among all isolates despite their detection in different ICU wards. All strains exhibited a pan-drug-resistant phenotype, showing resistance to every tested antimicrobial, including colistin. The mean duration of hospital stay was 61 days, and the mortality rate was 70.3 %, notably exceeding predicted mortality based on APACHE II scores and the background ICU mortality rate. Environmental cultures were all negative, possibly due to delayed sampling or limitations of conventional detection techniques. This study highlights the ability of M. odoratimimus to cause persistent clonal outbreaks in critical care settings, underscores its clinical significance as a multidrug-resistant pathogen, and emphasizes the need for early microbiological identification, molecular surveillance, and robust infection control strategies.
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    Rotavirus Antigen Positivity in Pediatric Patients: Retrospective Evaluation Based on Clinical and Laboratory Parameters
    (Doc Design Informatics Co Ltd, 2025) Karvar, Sinasi; Okumus, Elif
    Objective: Rotavirus is one of the leading viral agents of acute gastroenteritis, particularly in children under five years of age. This study aimed to analyze the association of rotavirus antigen positivity with age groups, seasonal distribution, hospital admission units, and laboratory parameters to contribute to diagnostic processes. Methods: This retrospective cross-sectional study included 23 568 children aged 0-18 years who underwent rotavirus antigen testing at Van Training and Research Hospital between January 1, 2022, and December 31, 2024. Demographic (age, sex) and clinical data were obtained retrospectively from the hospital information system (Karmed). Rotavirus antigen detection was performed on stool samples using the lateral flow (immunochromatographic) rapid test method. Results: Rotavirus antigen positivity was detected in 19.3% of the patients. The highest positivity rate was observed in the 1-4 year age group (24.9%), while the lowest was in the 12-17 year age group (4.5%) (p<0.0001). Positivity rates increased significantly during the autumn and winter months. Laboratory analysis revealed significantly lower leukocyte and lymphocyte counts, as well as potassium levels, in the positive group, whereas the percentage of neutrophils was significantly higher (p<0.0001). No patients showed evidence of severe fluid-electrolyte loss. Receiver operating characteristic (ROC) analysis revealed the highest area under the curve (AUC) for urea (0.599); in multivariate models, the maximum AUC was 0.648, indicating limited diagnostic power of the parameters. Conclusion: Rotavirus infections are most common in early childhood and during the winter months, generally presenting with a mild clinical course. Although statistically significant differences were found in laboratory parameters, they were not diagnostic in isolation and should be interpreted together with clinical findings. Our findings suggest that rotavirus test requests should be planned more effectively based on patient age, seasonal features, and symptomatic evaluation.