Browsing by Author "Devrim, İlker"
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Item 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; 7006095295Diverse 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.Item 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.; 7006095295Background: 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.Item 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; 6602154166Varicella 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.