Browsing by Author "Bozdemir, Şefika Elmas"

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Bursa il merkezinde 2 yaş altı çocuklarda alt solunum yolu enfeksiyonlarında respiratuvar sinsityal virüs sıklığı, klinik özellikleri ve tedavi maliyeti
(Uludağ Üniversitesi, 2013) Bozdemir, Şefika Elmas; Hacımustafaoğlu, Mustafa K.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Bilim Dalı.
Prospektif ve çok merkezli bu çalışmada, Türkiye'de Bursa il merkezinde 0-2 yaş arası alt solunum yolu enfeksiyonu (ASYE) nedeniyle hastaneye yatırılan olgularda Respiratuvar Sinsityal Virüs (RSV) epidemiyolojik özellikleri, klinik özellikleri ve maliyet analizinin değerlendirilmesi amaçlandı. Çalışmada RSV+ ASYE sıklığı %37.9, RSV+ akut bronşiolit sıklığı %41.0, RSV+ pnömoni sıklığı %34.0 olarak bulundu. Bursa il merkezinde ≤2 yaş RSV+ ASYE, RSV+ akut bronşiolit ve RSV+ pnömoni nedeniyle yıllık yatış insidanslarımız sırasıyla 7.8/1000, 4.6/1000 ve 3.2/1000 olarak hesaplandı. Bu sonuçlar Türkiye'ye yansıtıldığında, bir yılda ≤2 yaşta yaklaşık 453 500 olgunun ASYE nedeniyle hastaneye yatması bekleneceği ve bunların da tahmini olarak 18 800'ünün RSV+ ASYE yatışı olduğu tahmini olarak hesaplandı. Çalışmamızda RSV+ ASYE nedeniyle yatan bir olgunun ortalama yatış direkt tıbbi maliyeti 1 652.2 TL, 910.1 $ ve 721.0 € olarak hesaplandı. Toplam yatış maliyetleri tüm Türkiye bazında değerlendirildiğinde ise RSV+ ASYE nedeniyle yatış maliyetimizin yılda yaklaşık ortalama 419 658.8 TL, 231 178.7 $ ve 183 137.1 € olması beklenmektedir. Bu sonuçlara göre RSV enfeksiyonları halen ülkemizde < 2 yaşta ASYE'lerin önemli bir kısmını oluşturmakta ve önemli bir epidemiyolojik ve ekonomik hastalık yüküne neden olmaktadır.
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.
Çocuklarda tularemi: Tularemili 15 olgunun klinik, laboratuvar ve tedavi sonuçlarının değerlendirilmesi
(Uludağ Üniversitesi, 2013-03-12) Çelebi, Solmaz; Koyuncu, Ekrem; Bozdemir, Şefika Elmas; Çetin, Benhur Şirvan; Hacımustafaoğlu, Kemal; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Hastalıkları Bilim Dalı.
Giriş: Tularemi Francisella tularensis’in neden olduğu zoonotik hastalıktır. Bu çalışmanın amacı tularemi tanısı konan 15 çocuk olgunun klinik ve laboratuvar bulgularının değerlendirilmesidir. Gereç ve Yöntem: Çocuk Enfeksiyon Hastalıkları Polikliniğine ateş, boğaz ağrısı ve lenfadenopati (LAP) yakınması ile başvurup mikroaglütinasyon test (MAT) titresi 1/160 ve üstünde olan 15 olgu geriye dönük olarak değerlendirilerek sosyo-demografik özellikleri, hayvan ile temas ve kene ısırığı öyküleri, yakınma süreleri, klinik ve laboratuvar bulguları, tedavileri ve klinik gidişleri incelendi. Bulgular: Olguların yaş ortalaması 11,5±5,1 yıl (3-17) ve %53’ü erkek idi. Olguların %53,3’ü kırsal kesimde yaşıyor ve kuyu suyu kullanıyordu. En sık başvuru yakınmaları olan boyunda şişlik (%93,3), boğaz ağrısı (%66,7) ve ateş yüksekliği (%66,7) idi. Olgularda en sık orofarengeal tularemi (%66,7) saptandı. Cerrahi olarak olguların %27’sinin LAP’si boşaltılırken, %13,3’ünde ise LAP kendi kendine drene olmuştu. Bulgular başladıktan sonraki ortalama başvuru süresi 53±45,3 (5-150) gün bulundu. Başvuru öncesi olguların %60’ında betalaktam grubu antibiyotik alımı vardı. Lenf bezleri süpüre olan 6 olgunun başvuru ortancası 61 (20- 150)gün, diğerlerinin ise 35 (5-75) gün olarak saptandı p<0,05. Laboratuvar incelemelerinde; lökosit sayısı 8558,6±1384,5 (6030-11400)/mm3, CRP düzeyi 5,8±2,9 (1-6,7) mg/dl, ESH 33,1±28,9 (6-103) mm/saat olarak bulundu. MAT titreleri 1/160 ile 1/1280 arasında idi. Yedi (%47) olguya gentamisin, beş olguya (%33) streptomisin, üç olguya (%20) doksisiklin tedavisi uygulandı. Sonuç: Tularemi, kırsal alanda yaşayan ve beta-laktam antibiyotiklere yanıt vermeyen tonsilofarenjit ve servikal LAP’lı olgularda ayırıcı tanıda düşünülmelidir.
Comparison of c-reactive protein, procalcitonin and serum amyloid-a levels in diagnosis of bacterial infection in children
(Aves Yayincilik, Ibrahim Kara, 2013-12-01) Çelebi, Solmaz; ÇELEBİ, SOLMAZ; ÖZAKIN, CÜNEYT; Bulur, Nurcan; Hacımustafaoğlu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Özakın, Cüneyt; Çakır, Deniz; Bozdemir, Şefika Elmas; Çetin, Benhur Şirvan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Mikrobiyoloji Anabilim Dalı.; 0000-0003-4646-660X; 0000-0002-7056-0615; 0000-0002-8470-4907; GQP-2135-2022; AAG-8392-2021; H-2691-2017
Objective: The aim of the study was to compare C-reactive protein (CRP), procalcitonin (PCT) and serum amyloid A (SAA) levels in children with bacterial infection.Material and Methods: In this prospective study, 120 pediatric patients who were hospitalized with bacterial infection in the Uludag University Medical Faculty Pediatric Clinic between June 2009 and June 2011 were included. Patients were evaluated in 5 groups as sepsis, pneumonia, meningitis, pyelonephritis and other infection groups. Before initiating the antimicrobial therapy, blood samples for whole blood count, blood culture, CRP, PCT and SAA were obtained from children with bacterial infection. This procedure was repeated three times at 48 h, 7 and 10 days. Whole blood count was performed using an automated counter, Cell Dyn 3700 (Abbott Diagnostics Division, Santa Clara, CA, USA). CRP and SAA were determined by an immunonephelometric method using BN II device (Dade Behring Marburg GMBH, Marburg, Germany). PCT was measured by EnzymeLinked Fluorescent Assay (VIDAS PCT; Brahm Diagnostica GMBH, Lyon, France).Results: Of the patients, 66 (55%) were male and 54 (45%) were female. The median age was 37.5 months (1-209). PCT levels of the sepsis group was significantly higher than those of the pneumonia and other infection groups (respectively, p=0.001, p=0.003). SAA levels were higher in the meningitis group than those of the pneumonia group (p=0.007). When patients were divided into two groups as invasive bacterial infection group and localised bacterial infection group; PCT levels were found significantly higher in the invasive bacterial infection group than those of the localised bacterial infection group. Also, percentage change of PCT at the 48th hour, 7 and 10 days was determined as significantly higher in the invasive bacterial infection group than that of the localised bacterial infection group.Conclusion: In this study, PCT seems to be a more valuable parameter in diagnosing invasive bacterial infections.
Evaluation of cases with hydatid diseases
(Aves Yayincilik, Ibrahim Kara, 2009-09-01) Çakır, Deniz; GÜRPINAR, ARİF NURİ; Çelebi, Solmaz; ÇELEBİ, SOLMAZ; Gürpınar, Arif; Ağın, Mehmet; Bozdemir, Şefika Elmas; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Cerrahisi Anabilim Dalı.; 0000-0002-7056-0615; GQP-2135-2022
Objective: We aimed to evaluate the clinical data and prognosis of the cases of hydatid disease during a 8-year period who were followed up by the Pediatric Infectious Diseases Clinic.Methods: Demographic, clinical, laboratory data and prognosis of 41 patients with hydatid disease were evaluated between the period of 2000 to 2008 years retrospectively.Results: A total of 41 children were included in this study. There were 21 females (51%) and 20 males (49%). The patients were aged between 5 and 17 years with a mean of 11.50 +/- 3.14 years. Most children presented with the complaint of cough (36%), abdominal pain (29%) and rash (17%). Decreased breath sounds were observed in 46% of patients, urticarial rash in 12% of patients. The hydatid disease was located in the lung only in 37%, in the liver only in 35%, simultaneously in the lung and liver in 17%, and the spleen only in 5% of the all patients. A positive indirect hemagglutination assay result was obtained (titration >= 1/32) in 32 (78%) patients and a negative result was obtained in 9 (22%) patients initially. Albendazole was given as 15 mg/kg/day in two divided doses. The cure times were between 3 and 27 cycles with a mean of 7.31 +/- 5.75. In all, 71% of the patients were given medical treatment and underwent surgery, 12% of patients were given medical and invasive radiological procedures, 10% of patients were given medical treatment only and 7% of patients were given medical treatment, invasive radiological procedure and underwent surgery. All of the patients were cured. Recurrence of hydatid disease was not seen during the follow up period.Conclusion: Planning of the optimal treatment regimen of hydatid disease according to clinical involvement and characteristics of the patients can increase the treatment success. The cure may take a long time, although the patient undergoes surgery and invasive drainage.
Evaluation of patients with tuberculous meningitis
(Aves Yayıncılık, 2011-09-01) Bozdemir, Şefika Elmas; Çelebi, Solmaz; Hacımustafaoğlu, Mustafa; Çakır, Deniz; Aygün, F. Deniz; Çelik, Uğur; Sincar, Sahin; Özdener, Melek; Bozdemir, Şefika Elmas; ÇELEBİ, SOLMAZ; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Çakır, Deniz; Aygün, F. Deniz; KILIÇ, UĞUR; Sincar, Sahin; Özdener, Melek; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Hastalıkları Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0003-4646-660X; 0000-0002-7056-0615; AAC-9239-2021; GQP-2135-2022; HZV-5920-2023; JHN-1091-2023; CTG-5805-2022; JHS-0258-2023; FYK-3292-2022; FTD-2318-2022
Objective: Tuberculous meningitis is a form of extrapulmonary tuberculosis which has the highest mortality and morbidity rate. The aim of this study is to evaluate clinical signs and treatment regimens of patients with tuberculous meningitis.Material and Methods: Epidemiological properties, clinical signs, treatment regimens and prognosis of 11 patients with tuberculous meningitis in the Uludag University Medical Faculty Pediatric Infectious Disease Department between 2005- 2010 were evaluated.Results: Of the patients, 81.8% were boys with a mean age of 5.15 +/- 1.69 years (2 months- 15 years). The patients < 1year made up 36.3%. The most frequent complaints were fever and drowsiness in 45.5%, headache, nausea, vomiting in 18.2%, drowsiness in 18.2%. Physical examinations revealed fever and drowsiness in 63.6% and neck stiffness in 36.4%. Four patients (36.4%) had a person with active tuberculosis in his/her family. Tuberculin skin test (TST) was applied to all patients and resulted in > 15 mm enduration in 45.5%. BCG scarring was present in 72.7% of patients. Acid- alcohol- resistant bacillus (AARB) was seen in the cerebrospinal fluid (CSF) of 18.2% patients and grew Mycobacterium tuberculosis complex in cultures. Average cell count in CSF was 130 +/- 54.4, 75% lymphocyte in giemza staining. Average CSF protein 173.3 +/- 23.5 mg/dL, CSF chlorine 109.3 +/- 4.1mEq/L, CSF LDH 390.2 +/- 331.1 IU/L were found. Of the patients, 9.1% were in stage 1, 45.5% in stage 2 and 45.5% in stage 3 on admission. Cranial MRI revealed hydrocephaly + leptomeningeal staining in 45.5%, tuberculoma+ leptomeningeal staining in 18.2%, leptomeningeal staining in 27.3% and hydrocephaly in 9.1%. Of the patients, 81.8% were treated with izoniazid, rifampicin, pyrazinamid and streptomycine or ethambutole for two months initially, with izoniazid, rifampicin during the following 10 months. Prednisolone at 2 mg/kg/day was given to patients. Ventriculoperitoneal shunt was placed in 36.4% of patients for hydrocephalus. Neurological sequelae developed in 72.7% of patients. Of all the patients, 36.4% had mental- motor retardation, 27.3% learning difficulties and 9.1% hearing loss. One patient (9.1%) died.Conclusion: Because tuberculous meningitis is an infectious disease with high mortality and morbidity rates in childhood, rapid diagnosis and treatment is necessary for reducing complications.
Nosocomial infection incidence in pediatric clinic and pediatric intensive care unit
(Aves Yayıncılık, 2009-09-01) Hacımustafaoğlu, Mustafa; Çelebi, Solmaz; Tuncer, Esra; Özkaya, Güven; Çakır, Deniz; Bozdemir, Şefika Elmas; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; ÇELEBİ, SOLMAZ; Tuncer, Esra; ÖZKAYA, GÜVEN; Çakır, Deniz; Bozdemir, Şefika Elmas; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Kliniği; Uludağ Üniversitesi/Tıp Fakültesi/Bioistatistik Anabilim Dalı; 0000-0003-4646-660X; 0000-0003-0297-846X; 0000-0002-7056-0615; GQP-2135-2022; JWO-5132-2024; A-4421-2016; CTG-5805-2022; JHN-1091-2023; HZV-5920-2023
Objective: The aim of this study is the prospective evaluation of the rate of nosocomial infections (NCI) in our pediatric clinic (child and infant clinic, except newborn and hemato-oncology units) and pediatric intensive care unit (PICU).Methods: NCI defined by using the standard Centers for Diseases Control and Prevention (CDC) criteria.Results: Of 91 patients with NCI, there were 114 nosocomial infection attacks and 95 culture growths (1.25 episodes per patient). Forty-three percent (n=39) of patients were female, 57% (n=52) were male and the average age was 64.07 +/- 66.11 months in female patients and 53.14 +/- 63.26 months in male patients. Fifty-two percent (n=47) of the patients were admitted to the pediatric clinic and 48% (n=44) were in the PICU. NCI rates of PICU and pediatric clinic were 16.3 and 8.4 per 100 admissions and 18.5 and 17.3 per 1000 patient days, respectively. In total, the patients stayed in the hospital on average for 48.8 +/- 49.9 days (median=33 days) and the initial diagnosis of NCI was given on the 28.6 +/- 48.1st day of their admittance (median 16 days). The average hospital stay in the PICU patients was 47.2 +/- 60.7 days (median 31 days), and clinic patients 50.0 +/- 39.6 days (median 39 days). NCI was diagnosed on the 33.6 +/- 61.2 days of admittance (median 22.5 days) in the PICU and on the 24.2 +/- 32.6 days (median 10 days) in the clinic.Eighty-five of the 91 patients included in this study (93.4%) had a previously diagnosed underlying chronic or primary disease. The most frequent diseases were found as follows; neurological disease 37.4% (n=34), chronic renal disease 29.7% (n=27) and congenital heart disease 22% (n=20).Conclusion: It was found that NCI rates in our clinic were lower compared to the other developing
Potential cost-effectiveness of RSV vaccination of infants and pregnant women in Turkey: An illustration based on Bursa data
(Publication Library Science, 2016-09-10) Pouwels, Koen B.; Yeğenoğlu, Selen; McIntosh, E. David; Ünal, Serhat; Postma, Maarten J.; Bozdemir, Şefika Elmas; Çelebi, Solmaz; Hacımustafaoğlu, Mustafa; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Anabilim Dalı.; 36112591400; 7006095295; 6602154166
Background: Worldwide, respiratory syncytial virus (RSV) is considered to be the most important viral cause of respiratory morbidity and mortality among infants and young children. Although no active vaccine is available on the market yet, there are several active vaccine development programs in various stages. To assess whether one of these vaccines might be a future asset for national immunization programs, modeling the costs and benefits of various vaccination strategies is needed. Objectives: To evaluate the potential cost-effectiveness of RSV vaccination of infants and/or pregnant women in Turkey. Methods: A multicohort static Markov model with cycles of one month was used to compare the costeffectiveness of vaccinated cohorts versus nonvaccinated cohorts. The 2014 Turkish birth cohort was divided by twelve to construct twelve monthly birth cohorts of equal size (111,459 new-borns). Model input was based on clinical data from a multicenter prospective study from Bursa, Turkey, combined with figures from the (inter) national literature and publicly available data from the Turkish Statistical Institute (TUIK). Incremental costeffectiveness ratios (ICERs) were expressed in Turkish Lira (TL) per qualityadjusted life year (QALY) gained. Results Vaccinating infants at 2 and 4 months of age would prevent 145,802 GP visits, 8,201 hospitalizations and 48 deaths during the first year of life, corresponding to a total gain of 1650 QALYs. The discounted ICER was estimated at 51,969 TL (26,220 US $ in 2013) per QALY gained. Vaccinating both pregnant women and infants would prevent more cases, but was less attractive from a pure economic point of view with a discounted ICER of 61,653 TL (31,106 US $ in 2013) per QALY. Vaccinating only during pregnancy would result in fewer cases prevented than infant vaccination and a less favorable ICER. Conclusion: RSV vaccination of infants and/or pregnant women has the potential to be costeffective in Turkey. Although using relatively conservative assumptions, all evaluated strategies remained slightly below the threshold of 3 times the GDP per capita.
Primary solitary and multiple intracranial hydatid cyst disease: Report of four cases
(Aves Yayincilik, Ibrahim Kara, 2018-09-01) Çelebi, Solmaz; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; ÇELEBİ, SOLMAZ; Bozdemir, Şefika Elmas; Hacimustafaoğlu, Mustafa; TAŞKAPILIOĞLU, MEVLÜT ÖZGÜR; Taşkapılıoğlu, Özgür; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroşurji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; 0000-0001-5472-9065; 0000-0003-4646-660X; ABB-8161-2020
Four patients suffered from headache and vomiting at the time of diagnosis. A preoperative diagnosis of the disease was made thanks to cranial magnetic resonance imaging findings and indirect hemagglutination test for Echinococcus granulosus. Of these four children, three had cysts in cerebral localization and one in cerebellar localization. Two children had multiple and one of them had recurrent cerebral hydatid disease. All patients received albendazole treatment. While three patients did well after surgical excision, a ventriculoperitoneal shunt was placed in one. Also, this child was operated for duramater defect. Histopathological nad microbiological studies were performed for surgical specimens. We consider that primary hydatid disease of brain is still a difficult problem despite all advances in diagnostic methods and surgical techniques.
Relationship between the systemic immune-inflammatory index and the severity of acute bronchiolitis in children
(Oxford Univ Press, 2023-06-23) Kızılsoy, Ömer Furkan; Bozdemir, Şefika Elmas; Senkan, Gülsüm Elif; Korkmaz, Muhammet Furkan; Korkmaz, Merve; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.
Objective Acute bronchiolitis (AB) is one of the most common respiratory diseases in early childhood and is still an important health problem worldwide. The systemic immune-inflammatory index (SII) is thought to have potential to be a new-generation inflammatory biomarker. We sought to investigate the value of SII for severity assessment in children with AB. Methods A total of 74 AB patients were included in a prospective observational study. Patients were classified into 3 AB groups according to this classification: mild (1-5 points), moderate (6-10 points), and severe (11-12 points). Complete blood count, C-reactive protein, and procalcitonin tests were carried out. Modified Tal score was evaluated to determine severity. The performance of parameters to predict the severity of AB was assessed using the receiver operating characteristic (ROC). Results Whereas neutrophil count (P = .037), neutrophil-to-lymphocyte ratio (P = .030), and SII (P = .030) values increased significantly with disease severity, red cell distribution width (P = .048) values were higher in the moderate AB group. The SII was found to have the highest area under the curve in the comparison of the mild-moderate groups combination and the high group on ROC analysis (P = .009). Conclusion The SII values of pediatric patients hospitalized with the diagnosis of AB were significantly higher in the high-severity group. The SII may offer additional severity stratification in children with AB.
RSV frequency in children below 2 years hospitalized for lower respiratory tract infections
(Turkish J Pediatrics, 2013) Özcan, İsmail; Güray, Atilla; Hacımustafaoğlu, Mustafa Kemal; Çelebi, Solmaz; Bozdemir, Şefika Elmas; Özgür, Taner; Çakır, Deniz; Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Anabilim Dalı.; 0000-0002-7056-0615; AAG-8381-2021; GQP-2135-2022; CTG-5805-2022; JHN-1091-2023; HZV-5920-2023; 6602154166; 7006095295; 36112591400; 36087775800; 56421959600
Respiratory syncytial virus (RSV) is the most frequent agent of acute lower respiratory diseases and creates a significant burden of disease in children under 5 years all over the world. RSV causes severe lower respiratory tract infections (LRTI) that require hospitalization, especially in children <= 2 years. The aim of this study was to determine the incidence of RSV in children <= 2 years of age hospitalized for LRTI. Children <= 2 years of age hospitalized for one year for LRTI in the three largest hospitals of Bursa City Center, Turkey were evaluated. These three hospitals comprise 67.5% of all child beds in central Bursa, so this study allows us to evaluate the total disease burden and hospitalization incidence in central Bursa. Nasal swabs of the children were evaluated with RSV Respi Strip (Coris Bioconcept Organization).A total of 671 children were hospitalized for LRTI, and 254 (37.9%) had at least one hospitalization that was positive for RSV. Of all patients with LRTI, 54.8% (368/671) were hospitalized for acute bronchiolitis, while 45.2% (303/671) were hospitalized for pneumonia. Of patients with acute bronchiolitis or pneumonia, 41% (151/368) and 34% (103/303) were RSV+, respectively. Of RSV+ hospitalized children, 59.5% (151/254) were diagnosed as acute bronchiolitis and 40.5% (103/254) as pneumonia. The annual incidences of hospitalization due to LRTI, acute bronchiolitis and pneumonia were 20.5/1000, 11.2/1000 and 9.3/1000, respectively, in children <= 2 years of age. The annual incidences of hospitalization due to RSV+ LRTI, acute bronchiolitis and pneumonia were found as 7.8/1000, 4.6/1000 and 3.2/1000, respectively, in children <= 2 years of age. More than one-third of all children hospitalized with LRTI (38.3%, n=257) were in the 0-3 months age group. Compared to other age groups, RSV positivity was highest in that age group for acute bronchiolitis (57%), pneumonia (39.5%) and also total children with LRTI (47.9%). RSV is a very important cause of lower respiratory infections in children <= 2 years of age and occurred most frequently in those 0-3 months of age in our study. Since there is no other study assessing the annual hospitalization incidence of RSV+ LRTIs in one city in Turkey, our study has unique importance for providing valuable statistical data about RSV+ LRTIs.
SARS-CoV-2 seropositivity among pediatric health care personnel after the first peak of the pandemic: Nationwide surveillance in Turkey
(Elsevier, 2021-09-22) Oygar, Pembe Derin; Büyükçam, Ayşe; Bal, Zümrüt Şahbudak; Dalgıç, Nazan; Bozdemir, Şefika Elmas; Karbuz, Adem; Çetin, Benhür Şırvan; Kara, Yalçın; Çetin, Ceren; Hatipoğlu, Nevin; Uygun, Hatice; Aygün, Fatma Deniz; Torun, Selda Hançerli; Okur, Dicle Şener; Çiftdoğan, Dilek Yılmaz; Kara, Tuğçe Tural; Yahşi, Aysun; Özer, Arife; Demir, Sevliya Öcal; Akkoç, Gülsen; Turan, Cansu; Salı, Enes; Şen, Semra; Erdeniz, Emine Hafize; Kara, Soner Sertan; Emiroğlu, Melike; Erat, Tuğba; Aktürk, Hacer; Gürlevik, Sibel Laçinel; Sütcü, Murat; Aydın, Zeynep Gökçe Gayretli; Atıkan, Başak Yıldız; Yeşil, Edanur; Güner, Gizem; Çelebi, Emel; Efe, Kadir; İsançlı, Didem Kızmaz; Durmuş, Habibe Selver; Tekeli, Seher; Karaaslan, Ayşe; Bülbül, Lida; Almış, Habip; Kaba, Özge; Keleş, Yıldız Ekemen; Yazıcıoğlu, Bahadır; Oğuz, Şerife Bahtiyar; Ovalı, Hüsnü Fahri; Doğan, Hazal Helin; Çelebi, Solmaz; Çakır, Deniz; Karasulu, Burcugül; Alkan, Gülsüm; Yenidoğan, İrem; Gül, Doruk; Küçükalioğlu, Burcu Parıltan; Avcu, Gülhadiye; Kukul, Musa Gürel; Bilen, Melis; Yaşar, Belma; Üstün, Tuğba; Kılıç, Ömer; Akın, Yasemin; Cebeci, Sinem Oral; Bucak, İbrahim Hakan; Yanartaş, Mehpare Sarı; Şahin, Aslıhan; Arslanoğlu, Sertaç; Elevli, Murat; Çoban, Rabia; Öz, Sadiye Kübra Tüter; Hatipoğlu, Halil; Erkum, İlyas Tolga; Turgut, Mehmet; Demirbuğa, Asuman; Özçelik, Taha; Çiftci, Diclehan; Sarı, Emine Ergül; Akkuş, Gökhan; Hatipoğlu, Sadık Sami; Dinleyici, Ener Çağrı; Hacımustafaoğlu, Mustafa; Özkınay, Ferda; Kuruğol, Zafer; Cengiz, Ali Bülent; Somer, Ayper; Tezer, Hasan; Kara, Ateş; TURAN, CANSU; ÇELEBİ, SOLMAZ; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Anabilim Dalı.; IVB-4013-2023; JHN-1091-2023; CTG-5805-2022
Background: Understanding SARS-CoV-2 seroprevalence among health care personnel is important to ex-plore risk factors for transmission, develop elimination strategies and form a view on the necessity and frequency of surveillance in the future.Methods: We enrolled 4927 health care personnel working in pediatric units at 32 hospitals from 7 different regions of Turkey in a study to determine SARS Co-V-2 seroprevalence after the first peak of the COVID-19 pandemic. A point of care serologic lateral flow rapid test kit for immunoglobulin (Ig)M/IgG was used. Seroprevalence and its association with demographic characteristics and possible risk factors were analyzed.Results: SARS-CoV-2 seropositivity prevalence in health care personnel tested was 6.1%. Seropositivity was more common among those who did not universally wear protective masks (10.6% vs 6.1%). Having a COVID-19-positive co-worker increased the likelihood of infection. The least and the most experienced personnel were more likely to be infected. Most of the seropositive health care personnel (68.0%) did not suspect that they had previously had COVID-19.Conclusions: Health surveillance for health care personnel involving routine point-of-care nucleic acid testing and monitoring personal protective equipment adherence are suggested as important strategies to protect health care personnel from COVID-19 and reduce nosocomial SARS-CoV-2 transmission. (C) 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
Tuberculous lymphadenitis in children
(Aves Yayıncılık, 2012-03-01) Bozdemir, Şefika Elmas; Nazlıoğlu, Hülya Öztürk; Hacımustafaoğlu, Mustafa; Çelebi, Solmaz; Bozdemir, Şefika Elmas; ÖZTÜRK NAZLIOĞLU, HÜLYA; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; ÇELEBİ, SOLMAZ; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Hastalıkları Bilim Dalı; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı; 0000-0003-4646-660X; HZV-5920-2023; JIO-9152-2023; CTG-5805-2022; JHN-1091-2023
Objective: Tuberculous lymphadenitis is the most common form of extrapulmonary tuberculosis in childhood. The aim of this study is to evaluate the epidemiological and clinical signs and treatment results of patients with tuberculous lymphadenitis.Material and Method: Epidemiological properties, clinical signs, treatment regimens of 19 patients with tuberculous lymphadenitis proven by histopathological and/or microbiological evaluation in Uludag University Medical Faculty, Pediatric Infectious Disease Department between years 2005-2010 were evaluated.Results: Of patients, 68.4% were girls with a mean age of 7.45 +/- 4.59 years (12 months-16 years). The patients < 5 years were 31.5%. The most frequent complaint was swelling in 94.7% of patients. Three patients (15.8%) had a member with active tuberculosis in his/her family. One patient (5.3%) had been treated for pulmonary tuberculosis 2 years earlier. One patient (5.3%) had miliary and meningeal tuberculosis at the same time due to interferon gamma receptor deficiency. The tuberculin skin test (TST) was applied to all patients and resulted in > 15 mm enduration in 78.9%, 10-14 mm enduration in 21.1%, BCG vaccine scarring was present in 94.7% of patients while 57.9% had one scarring, 57.8% had two scarrings. The most frequent localization of disease was the cervical lymph nodes in 47.4%. In 94.7% of patients, diagnosis depended on revealing granulomatous inflammation and caseification necrosis of lymph nodes by excisional biopsy. Acid-alcohol-resistant bacillus (AARB) was seen and grew Mycobacterium tuberculosis complex in lymph node specimens of two of the patients who were diagnosed by lymph node biopsy. Side effects of antituberculous drug treatment were seen in 10.6% of patients. Of all patients, 94.7% recovered while one patient who had interferon gamma receptor deficiency died.Coclusion: Because tuberculous lymphadenitis is not a rare entity in children in our country, it must be considered in the differential diagnosis of lymphadenopathies.
Tularemia in children: Evaluation of clinical, laboratory and treatment outcomes of 15 tularemia cases
(Galenos Yayıncılık, 2013-08-01) Çelebi, Solmaz; Koyuncu, Ekrem; Bozdemir, Şefika Elmas; Çetin, Benhur Şirvan; Hacımustafaoğlu, Mustafa Kemal; ÇELEBİ, SOLMAZ; Koyuncu, Ekrem; Bozdemir, Şefika Elmas; Çetin, Benhur Şirvan; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Bilim Dalı.; 0000-0002-8470-4907; 0000-0003-4646-660X; H-2691-2017; JHN-1091-2023; CZY-1453-2022; HZV-5920-2023; CTG-5805-2022
Introduction: Tularemia is a zoonotic diseases caused by Francisella tularensis. The aim of this study was to evaluate the clinical and laboratory findings of 15 children with the diagnosis of tularemia.Materials and Methods: Fifteen cases admitted with fever, sore throat, lymphadenopathy and a F. tularensis antibody titer of 1/160 and above in the microagglutination test (MAT) were evaluated retrospectively. Their sociodemographic characteristics, contact with animals, history of tick bite, duration of complaints, clinical and laboratory findings, treatments and clinical courses were studied.Results: The mean age of patients was 11.5 +/- 5.1 (3-17) years and 61.3% were male. Fiftythree percent of the patients were living in rural areas, and had contact with contaminated water. Swelling in the neck (93.3%), sore throat (66.7%) and fever (66.7%) were the most frequently observed symptoms. Oropharyngeal tularemia (66.7%) was predominated. In 27% of the patients LAPs were drained surgically, and in 13.3% of cases they were drained by itself. The mean duration between onset of tularemia symptoms and diagnosis was 53 +/- 45.3 (5150) days. Sixty percent of patients were received beta-lactam-antibiotics before admission. It was noted that 6 patients with suppurative lymph nodes were admitted to hospital within median 61 (20-150) days, while others were admitted within median 35 (5-75) days (p< 0.05). Mean leukocyte count was 8558.6 +/- 1384.5 (6030-11400)/mm3, mean CRP was 5.8 +/- 2.9 (1-6.7) mg/dl, and mean ESR was 33.1 +/- 28.9 (6-103) mm/h. MAT showed that titers ranged from 1/160 to 1/1280. Gentamicin was given in seven patients (47%), streptomycin in five patients (33%), and doxycycline in 3 patients (20%).Conclusions: Tularemia should to be taken into account in the differential diagnosis in patients having tonsillopharyngitis and cervical lymphadenopathy without response to beta-lactam antibiotics in rural areas.