Browsing by Author "Bozdemir, Şefika Elmas"
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Item 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.Item 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; 6602154166Catheter-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.Item 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.Publication 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-2691-2017Objective: 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.Item 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; 6602154166Background: 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.Item 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; 56421959600Respiratory 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.Publication 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-5805-2022Background: 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.