Browsing by Author "Çelebi, Solmaz"

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A comparison of chlorhexidine and povidone-iodine solutions in neonatal intensive care units
(Wiley, 2023-01) Küçüker, Hakan; Çakır, Salih Çağrı; Köksal, Nirgül; Özkan, Hilal; Kocael, Fatma; Dorum, Bayram Ali; Yıldırım, Cansu Sivrikaya; Çelebi, Solmaz; Hacımustafaoğlu, Mustafa; KÜÇÜKER, HAKAN; ÇAKIR, SALİH ÇAĞRI; KÖKSAL, FATMA NİRGÜL; ÖZKAN, HİLAL; KOCAEL, FATMA; SİVRİKAYA YILDIRIM, CANSU; ÇELEBİ, SOLMAZ; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Dorum, Bayram Ali; Bursa Uludağ Üniversitesi/Tıp Fakültesi; 0000-0002-1636-5819; 0000-0001-5761-4757; 0000-0002-1787-6872; 0000-0003-4646-660X; 0000-0002-2823-8454; CZJ-5958-2022; HJZ-4508-2023; CZV-1969-2022; IGT-7005-2023; DXK-0792-2022; A-5375-2017; KGF-7434-2024; ENK-4130-2022; CTG-5805-2022
Background: Povidone-iodine (10%; PI) and 2% chlorhexidine in 70% isopropyl alcohol (CHG-IA) solutions are among the most widely used disinfectants in the neonatal intensive care units. This study compares the use of these disinfectants and helps decide which is superior to the other for neonatal use.Methods: All term and preterm infants born and hospitalized in Bursa Uludag University Hospital between July 2018-March 2020 were included. The infants were randomized into two disinfectant groups before birth. The application site was cleaned with the assigned disinfectant before intervention. The infants were screened for rates of neonatal sepsis, thyroid-stimulating hormone (TSH) levels, free thyroxine (fT4) levels, skin reactions to the assigned solution, and acute neurological side effects.Results: We enrolled 208 term and preterm infants (PI:104 vs. CHG-IA: 104) in the study. The prematurity rates were identical (PI: 74.0%; CHG-IA: 72.1%; p = 0.755). Neonatal sepsis rates among these groups were not statistically different (PI: 8.7%; CHG-IA: 4.8%; p = 0.406). The median TSH value of the PI group was high (4.05 mIU/L) in comparison with that of the CHG-IA group (3.09 mIU/L; p = 0.016). No cutaneous or neurological side effects were recorded in patients treated with CHG-IA solution.Conclusions: Although these two solutions were equally protective against infections, the CHG-IA solution was a better alternative to PI for neonatal use. Considering that the PI solution may be responsible for impaired thyroid function, the CHG-IA solution is a good alternative because it provides sufficient protection with a safer adverse effect profile.
A patient with breast mass and hyperemia
(Aves Yayıncılık, 2007-06-01) Aktürk, Berna; Çelebi, Solmaz; Aktürk, Berna; ÇELEBİ, SOLMAZ; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlıkları ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Hastalıkları Bilim; CAS-1783-2022; JOA-9028-2023
A three year-old child with persistent otalgia and fever
(Aves Yayincilik, Ibrahim Kara, 2007-03-01) Çelebi, Solmaz; ÇELEBİ, SOLMAZ; Hacımustafaoğlu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0003-4646-660X
Antifungal consumption, indications and selection of antifungal drugs in paediatric tertiary hospitals in Turkey: Results from the first national point prevalence survey
(Elsevier, 2018-08-07) Çelebi, Solmaz; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Anabilim Dalı.; 7006095295
Objectives: The aim of this point prevalence survey was to evaluate the consumption, indications and strategies of antifungal therapy in the paediatric population in Turkey. Methods: A point prevalence study was performed at 25 hospitals. In addition to general data on paediatric units of the institutes, the generic name and indication of antifungal drugs, the presence of fungal isolation and susceptibility patterns, and the presence of galactomannan test and high-resolution computed tomography (HRCT) results were reviewed. Results: A total of 3338 hospitalised patients were evaluated. The number of antifungal drugs prescribed was 314 in 301 patients (9.0%). Antifungal drugs were mostly prescribed in paediatric haematology and oncology (PHO) units (35.2%), followed by neonatal ICUs (NICUs) (19.6%), paediatric services (18.3%), paediatric ICUs (PICUs) (14.6%) and haematopoietic stem cell transplantation (HSCT) units (7.3%). Antifungals were used for prophylaxis in 147 patients (48.8%) and for treatment in 154 patients (50.0%). The antifungal treatment strategy in 154 patients was empirical in 77 (50.0%), diagnostic-driven in 29 (18.8%) and targeted in 48 (31.2%). At the point of decision-making for diagnostic-driven antifungal therapy in 29 patients, HRCT had not been performed in 1 patient (3.4%) and galactomannan test results were not available in 12 patients (41.4%). Thirteen patients (8.4%) were receiving eight different antifungal combination therapies. Conclusion: The majority of antifungal drugs for treatment and prophylaxis were prescribed in PHO and HSCT units (42.5%), followed by ICUs. Thus, antifungal stewardship programmes should mainly focus on these patients within the availability of diagnostic tests of each hospital
Antipyretic effect of ketoprofen
(Springer India, 2009-03) Aygün, Denizmen A.; Arısoy, Emin Sami; Seringeç, Murat; Çelebi, Solmaz; Hacımustafaoğlu, Mustafa Kemal; Karalı, Yasin; Akgöz, Semra; Kurt, Ayşegül Neşe Çıtak; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 7006095295; 49863694000; 6602154166; 14061863400; 36152868000
Objective. To investigate the efficacy and side effect of ketoprofen as well as compliance with respect to the taste of the drug and compare these parameters with those of acetaminophen and ibuprofen. Methods. A total of 301 patients between 1-14 years of age who attended to emergency rooms of three medical centers with the complaint of fever that required antipyretic therapy were included in the study. Fever was measured with the aid of a tympanic thermometer (Braun Kronberg 6014) and followed for 4-6 hours. The measurement was repeated at 30, 60, 120 minutes, and again 4-6 hours after the initial assessment. Results. The mean age of the patients was 47.8 +/- 41.1 months. The patients randomly received 15 mg/kg/dose of acetaminophen (n=112 group 1), 0.5 mg/kg/dose of ketoprofen (n=105, group 2), or 10 mg/kg/dose of ibuprofen (n=84, group 3). Temperature records in three groups was 38.4 +/- 0.7 degrees C, 38.4 +/- 0.7 degrees C, and 38.5 +/- 0.5 degrees C at 30 minutes; 38.0 +/- 0.7 degrees C, 37.9 +/- 0.7 degrees C, and 38.0 +/- 0.6 degrees C at 60 minutes (p > 0.05), 37.7 +/- 0.6 degrees C, 37.6 +/- 0.7 degrees C, and 37.7 +/- 0.5 degrees C at 120 minutes (p > 0.05); 37.5 +/- 0.7 degrees C, 37.3 +/- 0.6 degrees C, and 37.4 +/- 0.6 degrees C at 4-6 hours after admission (P > 0.05) respectively. The fever was significantly lower at 30, 60, and 120 minutes in all groups (p < 0.05) respectively. Early vomiting after medication (< 6 hours) was observed in 3.8%, 13.5%, and 9.6% respectively whereas late vomiting (6-48 hours) occurred in 1.3%, 2.7%, and 5.8% respectively (p > 0.05). Bad taste was expressed by 5.1%, 12.2%, and 5.8% early (< 6 hours), and 3.9%, 8.1%, and 3.8% late (6-48 hours) (p > 0.05). There were no differences between age groups for antipyretic effect, taste and adverse effect in three drugs (p > 0.05). Conclusion. All three drugs were similar in terms of efficacy, adverse effects, and compliance within 48 hours of therapy. These results suggest that ketoprofen may be used for antipyresis as an alternative to acetaminophen and ibuprofen.
Artritli çocuk olguların değerlendirilmesi: 9 yıllık retrospektif çalışma
(Bursa Uludağ Üniversitesi, 2020-06-06) Yeşil, Edanur; Çelebi, Solmaz; Özcan, Nur; Özer, Arife; Turan, Cansu; Bülbül, Beyhan; Ermutlu, Cenk; Sarısözen, Bartu; Hacımustafaoğlu, Bartu; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 0000-0002-8926-9959; 0000-0002-3536- 0263; 0000-0001-6093-6263; 0000-0001-9232- 0084; 0000-0003-3146-6391; 0000-0002- 5720-1212; 0000-0001-8259-3695; 0000- 0003-4071-8052; 0000-0003-4646-660X
Bu çalışmada, kliniğimize septik artrit öntanısı ile başvuran olguların klinik ve laboratuvar bulgularının ve tedavi yanıtlarının değerlendirilmesi amaçlandı. Ocak 2010-Ocak 2019 tarihleri arasında artrit öntanısıyla yatmış olan 111 çocuk (0-18 yaş) hasta kayıtları retrospektif incelendi. Olguların klinik, laboratuvar bulgularının değerlendirilmesi, tedavi ve prognostik özelliklerinin incelenmesi planlandı. Çalışmaya alınan toplam 111 hastanın %66’sı erkek olup ortalama yaşları 91±56 (medyan 83,1-215 aralığı) ay idi. Olguların çoğunluğunu (n=62,%56) 3-10 yaş aralığındaki hastalar oluşturdu. Olguların %60’ına (n=67) septik artrit tanısı konuldu. Bu tanıyı reaktif artrit (%10), juvenil idiopatik artrit (%10), toksik/geçici sinovit (%5) ve diğer artritler takip etti. Başvuruda olguların %96’sında ağrı, %63’ünde eklem şişliği, %21’inde kızarıklık, %41’inde eklemde ısı artışı, %64’ünde hareket kısıtlılığı, %38’inde yürüyememe yakınması vardı. Sıklıkla tutulan eklemler diz (%51) ve kalçaydı (%35). Ateş yüksekliği olan olgularda septik artrit olasılığı yüksek saptandı (p=0,0001). Septik artrit dışı artritlerde ibuprofene yanıt daha fazlaydı (p=0,0001). Olguların %55’ine (n=61) ponksiyon yapıldı, %34’ü (n=38) eklem içi debridman operasyonu geçirdi. Eklem sıvı kültüründe en sık üreyen mikroorganizmalar Staphylococcus aureus ve Streptococcus pyogenes idi. Septik artrit ile septik artrit dışı olgular karşılaştırıldığında, ultrasonografi ile ölçülen efüzyon miktarı, ponksiyonla alınan sıvı miktarı septik artrit grubunda istatistiksel olarak anlamlı oranda daha fazla, CRP ve lökosit sayısı ise septik artrit grubunda daha yüksek bulundu (sırasıyla p=0,001;p=0,025;p=0,018;p=0,032). Olguların %19’unda (n=21) osteomyelit saptanıp hepsi septik artrit grubundaydı Bu çalışmada ateşi olan, lökosit sayısı >12100/mm3 , CRP>3 mg/dl üzerinde olan olgularda, ultrasonografi ile 8,5 mm ve üzerinde efüzyon ölçülen olgularda septik artrit olma olasılığı istatistiksel anlamlı bulundu. Septik artrit dışı artritlerde ibuprofen yanıtı daha fazlaydı.
Aspergillosis
(Galenos Yayincilik, 2007-09-01) HACIMUSTAFAOĞLU, MUSTAFA KEMAL; ÇELEBİ, SOLMAZ; Çelebi, Solmaz; Aktürk, Berna; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0003-4646-660X
Ubiquitous saprophytic molds, Aspergillus species are common on decaying material throughout the world. More than 900 species are included in the genus Aspergillus. Among human beings 3 different clinical presentations including invasive disease, non-invasive disease and hypersensitivity reactions may occur due to Aspergillus species. Especially immunosuppressed patients are under the risk of invasive aspergillosis, and in consequence of extensive use of immunosuppresor medications and broad spectrum use of antibiotics, Aspergillus species gain importance among infectious diseases. In this article, pathology, pathophysiology, clinical pictures, diagnosis and treatment of invasive aspergillosis are overwieved.
Aspergilloz
(Uludağ Üniversitesi, 2007) Aktürk, Berna; Çelebi, Solmaz; Hacımustafaoğlu, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Hastalıkları Bilim Dalı.
Aspergillus türleri, 900 den fazla türü olan, tüm dünyada çürüyen materyal üzerinde sık ve yaygın olarak bulunan saprofit bir mantar ailesidir. İnsanlarda invaziv hastalık, invaziv olmayan hastalık ve aşırı duyarlılık sendromu olmak üzere üç farklı hastalık grubuna neden olurlar. Aspergillus türleri özellikle bağışıklık sisteminde sorun olan hastalarda ciddi enfeksiyonlara neden olan ve bağışıklık sistemini baskılayan ilaçların ve antibiyotiklerin yaygın olarak kullanılması ile önemi giderek artan enfeksiyonlara sebep olan mantarlardır. Bu yazıda özellikle invazif aspergilloz enfeksiyonunun patolojisi, patofizyolojisi, klinik tabloları, tanı ve tedavisi anlatılmaktadır.
Assessment of immune responses to hepatitis A vaccination in children aged 1 and 2 years
(TÜBİTAK, 2013) Çelebi, Solmaz; Hacımustafaoğlu, Mustafa Kemal; Albayrak, Yücehan; Sinirtaş, Ayşe Melda; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/ Mikrobiyoloji Anabilim Dalı.; 7006095295; 6602154166; 36165377200; 54788212600
Aim: Hepatitis A can be prevented by vaccination. The aim of this study was to determine seropositivity for hepatitis A before vaccination in healthy children 12 and 24 months of age and compare seroconversion rates after vaccination between these 2 groups. Materials and methods: Forty-nine children aged 1 year (Group 1) and 51 children aged 2 years (Group 2) were included in the study. Inactive hepatitis A vaccine (Avaxim, 80 antigenic subtypes, 0.5 mL) were administered to every child in 2 doses, 6 months apart. Anti-hepatitis A virus (HAV) IgG and IgM antibodies were detected by Architect HAVAb-IgG and HAVAb-IgM (Abbott, Wiesbaden, Germany) test kits. Results: Nine percent of the children were seropositive for anti-HAV IgG before vaccination. The seroconversion rate at 2 weeks was 34% and 44% in Group 1 and Group 2, respectively. At 4 weeks the seroconversion rate was 87.7% and 90.1% in Group 1 and Group 2, respectively. All of the children who completed the vaccination program were seropositive at 28 weeks (after the second dose). No serious adverse reaction was observed in any of the children. Conclusion: It was determined that Avaxim, including 80 antigen units, is safe and immunogenic in healthy children 12 and 24 months of age.
Bacterial agents causing meningitis during 2013-2014 in Turkey: A multi-center hospital-based prospective surveillance study
(Taylor & Francis, 2016-06-14) Hacımustafaoğlu, Mustafa; Çelebi, Solmaz; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Anabilim Dalı.; 6602154166; 7006095295
This is an observational epidemiological study to describe causes of bacterial meningitis among persons between 1 month and 18 y of age who are hospitalized with suspected bacterial meningitis in 7 Turkish regions. covering 32% of the entire population of Turkey. We present here the results from 2013 and 2014. A clinical case with meningitis was defined according to followings: any sign of meningitis including fever, vomiting, headache, and meningeal irritation in children above one year of age and fever without any documented source, impaired consciousness, prostration and seizures in those < 1 y of age. Single tube multiplex PCR assay was performed for the simultaneous identification of bacterial agents. The specific gene targets were ctrA, bex, and ply for N. meningitidis, Hib, and S. pneumoniae, respectively. PCR positive samples were recorded as laboratory-confirmed acute bacterial meningitis. A total of 665 children were hospitalized for suspected acute meningitis. The annual incidences of acute laboratory-confirmed bacterial meningitis were 0.3 cases / 100,000 population in 2013 and 0.9 cases/100,000 in 2014. Of the 94 diagnosed cases of bacterial meningitis by PCR, 85 (90.4%) were meningococcal and 9 (9.6%) were pneumococcal. Hib was not detected in any of the patients. Among meningococcal meningitis, cases of serogroup Y, A, B and W-135 were 2.4% (n = 2), 3.5% (n = 3), 32.9% (n = 28), and 42.4% (n = 36). No serogroup C was detected among meningococcal cases. Successful vaccination policies for protection from bacterial meningitis are dependent on accurate determination of the etiology of bacterial meningitis. Additionally, the epidemiology of meningococcal disease is dynamic and close monitoring of serogroup distribution is comprehensively needed to assess the benefit of adding meningococcal vaccines to the routine immunization program.
Brucellar brain abscess in a child
(Aves Yayıncılık, 2010-06-01) Çelebi, Solmaz; Hacımustafaoğlu, Mustafa; Sınırtaş, Melda; ÇELEBİ, SOLMAZ; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Sınırtaş, Melda; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji Anabilim Dalı.; 0000-0003-4646-660X; JHN-1091-2023; CTG-5805-2022; GAU-2987-2022
A ten-year-old boy developed symptoms consistent with brucellosis and was treated with combined tetracycline and streptomycin. Despite therapy, he abruptly developed dysarthria and fear of death. A cranial magnetic resonance imaging revealed an abscess. Brucella abortus was isolated from the blood culture. He recovered completely with doxycycline plus rifampicin therapy.
Brucellosis in childhood
(Aves Yayıncılık, 2011-06-01) Çelebi, Solmaz; Hacomustafaoğlu, Mustafa; Demirtaş, Fatih; Salı, Enes; Gül, Ülkü; Özel, Mustafa; ÇELEBİ, SOLMAZ; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Demirtaş, Fatih; Salı, Enes; Gül, Ülkü; Özel, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0003-4646-660X; 0000-0001-7708-3498; AAL-1515-2021; JHN-1091-2023; CTG-5805-2022; CNC-2567-2022; DPU-8078-2022; JBY-6966-2023
Objective: Brucellosis is still an important infectious disease, being widespread as endemic and sporadic cases in Turkey. The aim of this study was to evaluate clinical and laboratory findings, treatment modalities and final outcomes of brucellosis in children.Material and Methods: This is a retrospective record review of all patients 0-18 years of age with brucellosis admitted during a 8-year period between January 2003 and September 2010.Results: Of the 62 patients, 39 (63%) were male. The mean age and standard deviation of patients was 120 +/- 51.7 months (4 months-18 years). Most common symptoms on admission were fever (88%), arthralgia (64%) and dizziness (19%). On physical examination, the findings and percentages were as follows; arthritis (29%), lymphadenopathy (25%), hepatomegaly (24%) and splenomegaly (17%). Fiftyone percent of the patients had high sedimentation rate, 41% had high transaminase levels, and 40% had positivity for C-Reactive Protein. Brucella agglutination tests were positive in all cases. Brucella spp. was isolated from blood cultures in 27% of the cases. All of the cases were given combined drug therapy. Three of the cases (4.8%) had relapses during the follow up period. No mortality was seen in patients with brucellosis.Conclusion: Childhood brucellosis remains an important public health problem in our country. It may cause serious complications in children, and treatment with at least two antibiotics for not less than six weeks appears to be effective.
Brusellozis
(Uludağ Üniversitesi, 2004) Çelebi, Solmaz; Hacımustafaoğlu, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Hastalıkları Bilim Dalı.
Brusellozis enfekte hayvanlardan insanlara doğ- rudan temas, süt ve süt ürünlerinin taze olarak tüketilmesi ve/veya enfekte damlacıkların inhalasyonu ile bulaşabilen bir enfeksiyon hastalığıdır (1). Gelişmiş ülkelerde tamamen ortadan kaldırılmakla birlikte, hayvancılığın yoğun, çiğ süt ve süt ürünlerinin, tüketiminin yaygın olduğu ülkemizde ve gelişmekte olan ülkelerde halen önemli bir halk sağlığı sorunu olmaya devam etmektedir (2, 3). Hastalık ilk kez Hipokrat zamanında “humma” olarak tanımlanmıştır, 1886’da Bruce ilk kez etkeni izole etmiş, mikrokok olarak ifade etmiş ve bu etkenin yaptığı enfeksiyonu “Malta humması” olarak adlandırmıştır, 1895’de Bang düşük yapan sığırlardan “Bacillus abortus’u izole etmiş, 1920’de ise Alice Evara brusella terimini kullanmıştır. Hastalık için Malta ateşi, peynir hastalığı ya da ondülan ateş gibi isimler verilmiştir (4).
Bursa Uludağ Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Kliniğine tekrarlayan pnömoni nedeniyle yatışı yapılan çocuk olguların retrospektif değerlendirilmesi
(Bursa Uludağ Üniversitesi, 2022) Çetiner, Şükran; Çelebi, Solmaz; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.
Bursa Uludağ Üniversitesi Çocuk Enfeksiyon Hastalıkları Bilim Dalında 25 Mayıs 2017 ve 25 Mayıs 2022 tarihleri arasında tekrarlayan pnömoni nedeniyle yatışı yapılan 152 olgu retrospektif olarak incelenmiştir. Tekrarlayan pnömoni kriterleri ile uyumlu olan olguların yaş ortalaması 21,36 ± 16,61 ay ve %52’si erkek cinsiyetti. Olguların %44,7’sinde vücut ağırlığı <3 persentil altındaydı. Olguların %27,6’sında prematürite öyküsü ve %12,5’inde bronkopulmoner dizplazi (BPD) saptandı. Altta yatan hastalık olguların %92,7’sinde mevcut olup en sık %30,’unda nörolojik hastalık, %15,7’sinde konjenital kalp hastalığı (KKH) ve %12,5’inde gastroözefageal reflü (GÖR) mevcuttu. En sık başvuru yakınması %73 oranında öksürüktü. Hastalardan alınan kan örneklerinde %25,6’inde lökositoz ve %50’sinde CRP yüksekliği saptandı. Kan kültüründe %11,2’inde üremesi olup, %3,9’ünde Staphylococcus hominis saptanmıştı. Solunum PCR testi %32,2’sinde pozitif olup en sık etken %44,8 oranında Rinovirüs’tü. İnfiltrasyon bulgusu olguların %85,5’ünde göğüs grafisinde ve %79,2’sinde toraks bilgisayarlı tomografisinde (BT) saptandı. Yoğun bakım ünitesine (YBÜ) 24 olgu (%15,8) yatırıldı, %8,6’sı entübe edildi ve %9,2’si eksitus oldu. Birden fazla hastalık bulunan grupta boy uzunluğu ve vücut ağırlığı <3 persentil olan olguların sıklığının, birden fazla hastalığı olmayan gruba göre istatistiksel olarak anlamlı düzeyde daha fazla olduğu saptandı (p<0,05). Olguların semptom başlama yaşı ile tanı yaşı arasındaki korelasyona bakıldığında istatistiksel olarak anlamlılık göstermektedir (p<0,001). Altta yatan hastalık varlığı ile olguların geçirdikleri pnömoni atak sayısı arasındaki ilişkiye bakıldığında kistik fibrozis (KF) (p<0,001), aspirasyon sendromu (p=0,007) ve tüberkülozlu (TB) (p=0,003) olguların ortalama atak sayısı daha yüksek bulunmuştur.
Bursa Uludağ Üniversitesi Tıp Fakültesi çocuk sağlığı ve hastalıkları kliniklerinde kandidemi saptanan olgularda risk faktörlerinin belirlenmesi: Beş yıllık retrospektif çalışma
(Bursa Uludağ Üniversitesi, 2020) Ertek, Sümeyye; Çelebi, Solmaz; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.
Kandidemi, invaziv kandidiyazis olgularının en sık görülen enfeksiyon tipidir. Bu çalışmanın amacı, üçüncü basamak bir hastanenin çocuk kliniklerinde kandidemi olan olguların klinik ve laboratuvar bulgularını retrospektif olarak değerlendirmektir. Ocak 2013-Aralık 2017 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Klinikleri’nde yatarak izlenen olgular arasında toplam 37 olguda kandidemi atağı tespit edildi. Olguların %62’si erkek olup, ortanca yaşı 39.9 aydı (15 gün–192 ay). Olguların en sık altta yatan hastalığı hematolojik olmak üzere malignensiler (%30), takiben ise prematürite (%24) idi. Olguların %67’si (n=25) yoğun bakım ünitesinde izlenmekteydi, %54’ü (n=20) entübeydi. Olguların %81’inde (n=30) santral venöz kateter, %76’sında (n=28) total parenteral nutrisyon alımı, %42’sinde (n=16) geçirilmiş operasyon vardı. Olguların %38’i (n=14) immünsüpresan tedavi almakta olup %22’si (n=8) nötropenikti. Atakların %73’ünde (n=27) eşlik eden bakteriyemi durumu olup, olguların %80’i (n=30) kandidemi atağı sırasında eş zamanlı geniş spektrumlu antibiyotik alıyordu. Olguların %73’ünde albicans dışı kandidemilerde üremiş olup en sık C. parapsilosis (%45,9) izole edildi. Albicans dışı kandidalarda tam kan sayımında beyaz küre, nötrofil, trombosit sayıları daha düşük saptandı (sırasıyla p=0.009, p=0.004, p=0.022). Olguların %27’si (n=10) kaybedilmiş olup, albicans ve albicans dışı kandidemiler arasında mortalite açısından istatistiksel fark görülmedi (p=0,694). Trombositopeni varlığı ve mekanik ventilasyon uygulaması mortaliteyi artıran risk faktörleri olarak bulundu (sırasıyla p=0.01, p=0.01). Sonuç olarak, çalışmamızda kandidemili olguların çoğunun yoğun bakım ünitesinde entübe olarak izlendiği, büyük çoğunluğunun ise geniş spektrumlu antibiyotik aldığı, santral venöz kateteri olup total parenteral nutrisyon aldığı gözlendi. Çalışmamızda kandidemili çocuklarda mortalite oranı %27 olup, mekanik ventilasyon uygulanması ve trombositopeni varlığı mortaliteyi etkileyen faktörler olarak saptandı.
Candida infections in non-neutropenic children after the neonatal period
(Taylor & Francis, 2011-10) Hacımustafaoğlu, Mustafa Kemal; Çelebi, Solmaz; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri ve Pediatri Enfeksiyon Hastalıkları Anabilim Dalı.; 6602154166; 7006095295
There are a variety of diseases, from local mucous membrane infections to invasive systemic infections, that are caused by Candida species. As a causative agent, Candida albicans is the most common; however, the other Candida species can also cause the same clinical syndromes. Most invasive fungal infections in children occur in the hospital setting. Candidemia is a serious condition associated with high morbidity and mortality and increased healthcare costs in pediatric patients. Children at the highest risk are those with prolonged intensive care unit stays, reduced immune function, recent surgery, prior bacterial infection, prior use of antibiotics and/or corticosteroids and other immunosuppressive agents, as well as use of a central venous catheter, total parenteral nutrition, mechanical ventilation and dialysis. Positive blood culture is the gold standard of candidemia; it should not be accepted as contamination or colonization in children with an intravascular catheter. However, in oropharyngeal or vulvovaginal candidiasis, culture of lesions is rarely indicated unless the disease is recalcitrant or recurrent. Recovery of Candida from the sputum should usually be considered as colonization and should not be treated with antifungal therapy. Antigen and antibody detecting tests are evaluated in invasive Candida infections; however, there are no published results in children, and their roles in diagnosis are also unclear. For the therapy of invasive Candida infections in non-neutropenic patients, fluconazole or an echinocandin is usually recommended. Alternatively, amphotericin B deoxycholate or lipid formulations of amphotericin B can also be used. The recommended therapy of Candida meningitis is amphotericin B combined with flucytosine. The combination therapy for Candida infections is usually not indicated. Prophylaxis in non-neonatal, immunocompetent children is not recommended.
Catheter-associated bloodstream infections in pediatric hematology-oncology patients
(Taylor & Francis, 2013-04) Çelebi, Solmaz; Sezgin, Melike Evim; Çakır, Deniz; Baytan, Birol; Demirkaya, Metin; Sevinir, Betül Berrin; Bozdemir, Şefika Elmas; Güneş, Adalet Meral; Hacımustafaoğlu, Mustafa Kemal; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; AAH-1570-2021; 7006095295; 55316683800; 56421959600; 6506622162; 24331130000; 6603199915; 36112591400; 24072843300; 6602154166
Catheter-associated bloodstream infections (CABSIs) are common complications encountered with cancer treatment. The aims of this study were to analyze the factors associated with recurrent infection and catheter removal in pediatric hematology-oncology patients. All cases of CABSIs in patients attending the Department of Pediatric Hematology-Oncology between January 2008 and December 2010 were reviewed. A total of 44 episodes of CABSIs, including multiple episodes involving the same catheter, were identified in 31 children with cancer. The overall CABSIs rate was 7.4 infections per 1000 central venous catheter (CVC) days. The most frequent organism isolated was coagulase-negative Staphylococcus (CONS). The CVC was removed in nine (20.4%) episodes. We found that hypotension, persistent bacteremia, Candida infection, exit-side infection, neutropenia, and prolonged duration of neutropenia were the factors for catheter removal. There were 23 (52.2%) episodes of recurrence or reinfection. Mortality rate was found to be 9.6% in children with CABSIs. In this study, we found that CABSIs rate was 7.4 infections per 1000 catheter-days. CABSIs rates in our hematology-oncology patients are comparable to prior reports. Because CONS is the most common isolated microorganism in CABSIs, vancomycin can be considered part of the initial empirical regimen.
Changing epidemiology of influenza and other respiratory viruses in the first year of COVID-19 pandemic
(Elsevier Science London, 2021-09) Ağca, Harun; Akalın, Halis; Sağlık, İmran; Hacımustafaoğlu, Mustafa; Çelebi, Solmaz; Ener, Beyza; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Temel Tıp Bilimleri/Tıbbi Mikrobiyoloji.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri/Enfeksiyon Hastalıkları Ve Klinik Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Temel Tıp Bilimleri/Tıbbi Mikrobiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri/Çocuk Sağlığı Ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri/Çocuk Sağlığı Ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Temel Tıp Bilimleri/Tıbbi Mikrobiyoloji Anabilim Dalı.; 0000-0002-2651-2034; 0000-0002-4803-8206; AAH-4027-2021; AAU-8952-2020; GCM-3391-2022; CTG-5805-2022; ENK-4130-2022; AAG-8523-2021; 15759379900; 57207553671; 35732173500; 6602154166; 7006095295; 15053025300
Introduction: We aimed to determine the epidemiological change in influenza and other respiratory tract viruses isolated from patients with nasopharyngeal swab samples in our hospital during the COVID-19 period. Methods: We investigated nasopharyngeal swabs for respiratory viruses between March 2020 and February 2021 during the first year of pandemic in Turkey. We used QIAStat Dx Respiratory panel (Qiagen, Germany) in QIAStat Dx (Qiagen, Germany) for detection of respiratory viruses between March 2020 and February 2021. Respiratory panel kit included influenza A, B, influenza A H1N1, rhinovirus/enterovirus, parainfluenza (PIV) 1,2,3,4, coronaviruses (CoVs) NL 63, 229E, OC43 and HKU1, human metapneumovirus (MPV) A/B, bocavirus, respiratory syncytial virus (RSV) A/B and adenovirus. Results: We retrospectively analyzed the results of 319 nasopharyngeal swab samples. The average age of 199 (62.4%) male and 120 (37.6%) female patients between the ages of 0-92 was 16 years. We found that 101 (31.7%) samples were positive for viruses. Rhino/enteroviruses were the most common viruses in all age groups. Influenza positivity rate during the first year of pandemic declined to 2.3% from 17.3% among the previous year. MPV infection activity did not change during the pandemic. Discussion: According to our findings we argue that epidemiology of respiratory viruses has changed during the pandemic period. Despite the current clinical focus on the COVID-19 pandemic, clinicians should keep in mind that rhino/enterovirus and MPV infections may mimic COVID-19 and respiratory infections should be differentially diagnosed with rapid multiplex kits containing SARS-CoV-2, rhino/enterovirus and MPV. (c) 2021 The Authors. Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY license (http://creativecommons.org/ licenses/by/4.0/).
Characterization of invasive Neisseria meningitidis isolates recovered from children in Turkey during a period of increased serogroup B disease, 2013-2017
(Elsevier, 2020-04-23) Ceyhan, Mehmet; Özsürekçi, Yasemin; Lucidarme, Jay; Borrow, Ray; Gürler, Nezahat; Emiroğlu, Melike Keser; Öz, Fatma Nur; Kurugöl, Zafer; Çelik, Ümit; Parlakay, Aslınur Özkaya; Dinleyici, Ener Çağrı; Karbuz, Adem; Belet, Nursen; Devrim, İlker; Gülfidan, Gamze; Gündeşlioğlu, Özlem; Yücel, Mihriban; Ulusoy, Emel; Cengiz, Ali Bülent; Çelebi, Solmaz; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Anabilim Dalı.; ENK-4130-2022; 7006095295
Diverse Neisseria meningitidis strains belonging to various serogroups and clonal complexes cause epidemic and endemic life-threatening disease worldwide. This study aimed to investigate the genetic diversity of recent invasive meningococci in Turkey with respect to multilocus sequence type (MLST) and also meningococcal serogroup B (MenB) vaccine antigens to enable assessment of potential MenB strain coverage using the genetic Meningococcal Antigen Typing System (gMATS). Fifty-four isolates, representing 37.5% of all pediatric (ages 0-18 years) invasive meningococcal disease cases in Turkey from January 2013 to December 2017, underwent genome sequence analysis. Thirty-six (66.7%) isolates were MenB, 10 (18.5%) were serogroup W (MenW), 4 (7.4%) were serogroup A (MenA), 3 (5.6%) were serogroup Y (MenY) and 1 (1.8%) was serogroup X (MenX). The MenB isolates were diverse with cc35 (19.4%), cc41/44 (19.4%) and cc32 (13.8%) as the most prevalent clonal complexes. The MenW isolates (n = 10) comprised cc11 (n = 5), ST-2754 (cc-unassigned; n = 4) and cc22 (n = 1). gMATS was indicative of high 4CMenB coverage (72.2-79.1%) of Turkish invasive MenB strains from pediatric patients. Strain coverage of several clonal complexes differed from that seen elsewhere in Europe highlighting the importance of performing local assessments and also the use of phenotypic methods, i.e. MATS, where possible. All of the isolates possessed in-frame fhbp alleles and so were potentially covered by MenB-fHbp. Continued surveillance is essential to guide recommendations for current and future vaccines as well as understanding changes in epidemiology.
Clinical and epidemiological features of Turkish children with 2009 pandemic influenza A (H1N1) infection: Experience from multiple tertiary paediatric centres in Turkey
(Informa Healthcare, 2011-12) Çiftçi, Ergin; Tuygun, Nilden; Özdemir, Halil; Tezer, Hasan; Şensoy, Gülnar; Devrim, İlker; Dalgıç, Nazan; Kara, Ateş; Turgut, Mehmet; Tapısız, Anıl; Keser, Melike; Bayram, Nuri; Kocabaş, Emine; Dinleyici, Ener Çağrı; Özen, Metehan; Soysal, Ahmet; Kuyucu, Necdet; Tanır, Gönül; Çelikel, Elif; Belet, Nursen; Evren, Gültaç; Aytaç, Didem Büyüktaş; Cengiz, Ali Bülent; Canoz, Perihan Yasemen; Derinoz, Oksan; İnce, Erdal; Hacımustafaoğlu, Mustafa; Anıl, Murat; Özgür, Özlem; Kuzdan, Canan; Özaydin, Eda; Aşılıoğlu, Nazik; Dizdarer, Ceyhun; Ceyhan, Mehmet; Bucak, İbrahim Hakan; Kendirli, Tanıl; Yakut, Halil İbrahim; Fisgin, Tunç; Unal, Nurettin; Altındağ, Hakan; Kılınç, Ayse Ayzit; Zohre, Seray Umut; Elhan, Atilla Halil; Doğru, Ülker; Çelebi, Solmaz; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Anabilim Dalı.; 7006095295
Background: In April 2009 a novel strain of human influenza A, identified as H1N1 virus, rapidly spread worldwide, and in early June 2009 the World Health Organization raised the pandemic alert level to phase 6. Herein we present the largest series of children who were hospitalized due to pandemic H1N1 infection in Turkey. Methods: We conducted a retrospective multicentre analysis of case records involving children hospitalized with influenza-like illness, in whom 2009 H1N1 influenza was diagnosed by reverse-transcriptase polymerase chain reaction assay, at 17 different tertiary hospitals. Results: A total of 821 children with 2009 pandemic H1N1 were hospitalized. The majority of admitted children (56.9%) were younger than 5 y of age. Three hundred and seventy-six children (45.8%) had 1 or more pre-existing conditions. Respiratory complications including wheezing, pneumonia, pneumothorax, pneumomediastinum, and hypoxemia were seen in 272 (33.2%) children. Ninety of the patients (11.0%) were admitted or transferred to the paediatric intensive care units (PICU) and 52 (6.3%) received mechanical ventilation. Thirty-five children (4.3%) died. The mortality rate did not differ between age groups. Of the patients who died, 25.7% were healthy before the H1N1 virus infection. However, the death rate was significantly higher in patients with malignancy, chronic neurological disease, immunosuppressive therapy, at least 1 pre-existing condition, and respiratory complications. The most common causes of mortality were pneumonia and sepsis. Conclusions: In Turkey, 2009 H1N1 infection caused high mortality and PICU admission due to severe respiratory illness and complications, especially in children with an underlying condition.