Browsing by Author "Alhan, Emre"

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Distribution of Streptococcus pneumoniae serotypes that cause parapneumonic empyema in Turkey
(American Society for Microbiology, 2013-04-15) Ceyhan, Mehmet; Özsürekçi, Yasemin; Gürler, Nezahat; Özkan, Şengül; Şensoy, Gülnar; Belet, Nurşen; Keser, Melike; Dinleyici, Ener Cağrı; Alhan, Emre; Baki, Ali; Öner, Ahmet Faik; Uzun, Hakan; Kurugöl, Zafer; Aycan, Ahmet Emre; Gürbüz, Venhar; Karadağ Öncel, Eda; Çelik, Melda; Parlakay, Aslınur Özkaya; Hacımustafaoğlu, Mustafa Kemal; Çelebi, Solmaz; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Anabilim Dalı.; CTG-5805-2022; ENK-4130-2022; 6602154166; 7006095295
Streptococcus pneumoniae is the most common etiological cause of complicated pneumonia, including empyema. In this study, we investigated the serotypes of S. pneumoniae that cause empyema in children. One hundred fifty-six children who were diagnosed with pneumonia complicated with empyema in 13 hospitals in seven geographic regions of Turkey between 2010 and 2012 were included in this study. Pleural fluid samples were collected by thoracentesis and tested for 14 serotypes/serogroups using a Bio-Plex multiplex antigen detection assay. The serotypes of S. pneumoniae were specified in 33 of 156 samples. The mean age ± the standard deviation of the 33 patients was 6.17 ± 3.54 years (range, 0.6 to 15 years). All of the children were unvaccinated according to the vaccination reports. Eighteen of the children were male, and 15 were female. The serotypes of the non-7-valent pneumococcal conjugated vaccine (non-PCV-7), serotype 1, serotype 5, and serotype 3, were detected in eight (14.5%), seven (12.7%), and five (9.1%) of the samples, respectively. Serotypes 1 and 5 were codetected in two samples. The remaining non- PCV-7 serotypes were 8 (n = 3), 18 (n = 1), 19A (n = 1), and 7F/A (n = 1). PCV-7 serotypes 6B, 9V, 14, 19F, and 23F were detected in nine (16.3%) of the samples. The potential serotype coverages of PCV-7, PCV-10, and PCV-13 were 16.3%, 45.4%, and 60%, respectively. Pediatric parapneumonic empyema continues to be an important health problem despite the introduction of conjugated pneumococcal vaccines. Active surveillance studies are needed to monitor the change in S. pneumoniae serotypes that cause empyema in order to have a better selection of pneumococcal vaccines.
The epidemiology and economic impact of varicella-related hospitalizations in Turkey from 2008 to 2010: A nationwide survey during the pre-vaccine era (VARICOMP study)
(Springer, 2012-05) Dinleyici, Ener Çağrı; Kurugöl, Zafer; Türel, Özden; Hatipoğlu, Nevin; Devrim, İlker; Ağın, Hasan; Günay, İlker; Yaşa, Olcay; Ergüven, Müferet; Bayram, Nuri; Kızıldemir, Ali; Alhan, Emre; Kocabaş, Emine; Tezer, Hasan; Aykan, H. Hakan; Dalgıç, Nazan; Kılıç, Betül; Şensoy, Gülnar; Belet, Nursen; Kulcu, Nihan Uygur; Say, Aysu; Taş, Mehmet Ali; Çiftçi, Ergin; İnce, Erdal; Özdemir, Halil; Emiroğlu, Melike; Odabaş, Dursun; Yargıç, Zeynel Abidin; Nuhoğlu, Çağatay; Çarman, Kürşat Bora; Elevli, Murat; Ekici, Zahide; Çelik, Ümit; Kondolot, Meda; Öztürk, Mustafa; Tapısız, Anıl; Özen, Metehan; Tepeli, Harun; Parlakay, Aslınur; Kara, Ateş; Somer, Ayper; Çalışkan, Bahar; Velipaşalıoğlu, Sevtap; Öncel, Selim; Arısoy, Emin Sami; Güler, Ekrem; Dalkıran, Tahir; Aygün, Denizmen; Akarsu, Saadet; Çelebi, Solmaz; Hacımustafaoğlu, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi.; 0000-0002-3536-0263; 0000-0003-4646-660X; ENK-4130-2022; CTG-5805-2022; 7006095295; 6602154166
Varicella can cause complications that are potentially serious and require hospitalization. Our current understanding of the causes and incidence of varicella-related hospitalization in Turkey is limited and sufficiently accurate epidemiological and economical information is lacking. The aim of this study was to estimate the annual incidence of varicella-related hospitalizations, describe the complications, and estimate the annual mortality and cost of varicella in children. VARICOMP is a multi-center study that was performed to provide epidemiological and economic data on hospitalization for varicella in children between 0 and 15 years of age from October 2008 to September 2010 in Turkey. According to medical records from 27 health care centers in 14 cities (representing 49.3% of the childhood population in Turkey), 824 children (73% previously healthy) were hospitalized for varicella over the 2-year period. Most cases occurred in the spring and early summer months. Most cases were in children under 5 years of age, and 29.5% were in children under 1 year of age. The estimated incidence of varicella-related hospitalization was 5.29-6.89 per 100,000 in all children between 0-15 years of age in Turkey, 21.7 to 28 per 100,000 children under 1 year of age, 9.8-13.8 per 100,000 children under 5 years of age, 3.96-6.52 per 100,000 children between 5 and 10 years of age and 0.42 to 0.71 per 100,000 children between 10 and 15 years of age. Among the 824 children, 212 (25.7%) were hospitalized because of primary varicella infection. The most common complications in children were secondary bacterial infection (23%), neurological (19.1%), and respiratory (17.5%) complications. Secondary bacterial infections (p < 0.001) and neurological complications (p < 0.001) were significantly more common in previously healthy children, whereas hematological complications (p < 0.001) were more commonly observed in children with underlying conditions. The median length of the hospital stay was 6 days, and it was longer in children with underlying conditions (< 0.001). The median cost of hospitalization per patient was $338 and was significantly higher in children with underlying conditions (p < 0.001). The estimated direct annual cost (not including the loss of parental work time and school absence) of varicella-related hospitalization in children under the age of 15 years in Turkey was $856,190 to $1,407,006. According to our estimates, 882 to 1,450 children are hospitalized for varicella each year, reflecting a population-wide occurrence of 466-768 varicella cases per 100,000 children. In conclusion, this study confirms that varicella-related hospitalizations are not uncommon in children, and two thirds of these children are otherwise healthy. The annual cost of hospitalization for varicella reflects only a small part of the overall cost of this disease, as only a very few cases require hospital admission. The incidence of this disease was higher in children < 1 year of age, and there are no prevention strategies for these children other than population-wide vaccination. Universal vaccination is therefore the only realistic option for the prevention of severe complications and deaths. The surveillance of varicella-associated complications is essential for monitoring of the impact of varicella immunization.
Inappropriate antimicrobial use in Turkish pediatric hospitals: A multicenter point prevalence survey
(Elsevier, 2010-01) Ceyhan, Mehmet; Yıldırım, İnci; Ecevit, Çiğdem Ömür; Aydoğan, Aysel; Örnek, Ahmet Haydar; Salman, Nuran; Somer, Ayper; Hatipoğlu, Nevin; Camcıoğlu, Yıldız; Alhan, Emre; Hacımustafaoğlu, Mustafa Kemal; Çelebi, Solmaz; İnan, Dilara; Kurt, Neşe Çitak; Öner, Ahmet Faik; Gülümser, Özlem; Güneş, Adalet Meral; Coşkun, Yavuz; Çelik, Ümit; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 9843305700
Objectives: Although well-defined principles of rational antimicrobial use are available, inappropriate prescribing patterns are reported worldwide. Accurate information on the usage of antimicrobials, including factors associated with and influencing their use, is valuable for improving the quality of prescription practices. Methods: In this cross-sectional point prevalence survey, data on patients hospitalized in 12 different children's hospitals were collected on a single day. Appropriateness of prescription was compared between the types of antimicrobials prescribed, indications, wards, and presence of/consultation with an infectious disease physician (IDP). Results: A total 711 of 1302 (54.6%) patients evaluated were receiving one or more antimicrobial drugs. The antimicrobial prescription rate was highest in pediatric intensive care (75.7%) and lowest in the surgery wards (37.0%). Of the 711 patients receiving antimicrobials, 332 patients (46.7%) were found to be receiving at least one inappropriately prescribed drug. Inappropriate use was most frequent in surgery wards (80.2%), while it was less common in oncology wards (31.8%; p < 0.001). Respiratory tract infection was the most common indication for antimicrobial use (29.4%). Inappropriate use was more common in deep-seated infections (54.7%) and respiratory infections (56.5%). Fluoroquinolones were used inappropriately more than any other drugs (81.8%, p = 0.021). Consultation with an IDP appears to increase appropriate antimicrobial use (p = 0.008). Conclusions: Inappropriate antimicrobial use remains a common problem in Turkish pediatric hospitals. Consultation with an IDP and prescribing antimicrobial drugs according to microbiological test results could decrease the inappropriate use of antimicrobials.
Meningitis caused by neisseria meningitidis, hemophilus influenzae type b and streptococcus pneumoniae during 2005-2012 in Turkey a multicenter prospective surveillance study
(Taylor & Francis Inc, 2014-09-01) Ceyhan, Mehmet; Gurler, Nezahat; Özsürekci, Yasemin; Keser, Melike; Aycan, Ahmet Emre; Gürbüz, Venhar; Salman, Nuran; Camcıoğlu, Yildiz; Dinleyici, Ener Cağrı; Özkan, Şengül; Şensoy, Gülnar; Belet, Nursen; Alhan, Emre; Uzun, Hakan; Öner, Ahmet Faik; Kurugol, Zafer; Taş, Mehmet Ali; Aygün, Denizmen; Öncel, Eda Karadağ; Çelik, Melda; Yasa, Olcay; Akın, Fatih; Coşkun, Yavuz; Hacimustafaoglu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Celebi, Solmaz; ÇELEBİ, SOLMAZ; Bursa Uludağ Üniversitesi/Tıp Fakültesi
Successful vaccination policies for protection from bacterial meningitis are dependent on determination of the etiology of bacterial meningitis. Cerebrospinal fluid (CSF) samples were obtained prospectively from children from 1 month to <= 18 years of age hospitalized with suspected meningitis, in order to determine the etiology of meningitis in Turkey. DNA evidence of Neisseria meningitidis (N. meningitidis), Streptococcus pneumoniae (S. pneumoniae), and Hemophilus influenzae type b (Hib) was detected using multiplex polymerase chain reaction (PCR). In total, 1452 CSF samples were evaluated and bacterial etiology was determined in 645 (44.4%) cases between 2005 and 2012; N. meningitidis was detected in 333 (51.6%), S. pneumoniae in 195 (30.2%), and Hib in 117 (18.1%) of the PCR positive samples. Of the 333 N. meningitidis positive samples 127 (38.1%) were identified as serogroup W-135, 87 (26.1%) serogroup B, 28 (8.4%) serogroup A and 3 (0.9%) serogroup Y; 88 (26.4%) were non-groupable. As vaccines against the most frequent bacterial isolates in this study are available and licensed, these results highlight the need for broad based protection against meningococcal disease in Turkey.