Person: YEŞİL, EDANUR
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Publication Evaluation of methicillin resistant staphylococcus aureus infection in children(Galenos Yayincilik, 2019-01-01) Yeşil, Edanur; ÇELEBİ, SOLMAZ; YEŞİL, EDANUR; Çelebi, Solmaz; Özer, Arife; Hacımustafaoğlu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Tıp Fakültesi; Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı; 0000-0002-8926-9959; 0000-0003-4646-660X; GSO-3630-2022BACKGROUND: This study was conducted to investigate cases of methicillin-resistant Staphylococcus aureus (MRSA) infections and also to draw attention to community-acquired MRSA in patients hospitalized at our Pediatric Clinics.METHODS: The patients who had meaningful S. aureus growth in the cultures taken from the patients who were hospitalized in Uludag University Medical Faculty Children's Health and Diseases Clinics between October 2012-February 2017 were included in the study. SPSS 17.0 program was used for statistical analysis.RESULTS: A total of 31 S. aureus infections were detected during this period. Seventeen (54.8%) of the cases with S. aureus infection were health care related. Methicillin-resistant S. aureus was present in 12 (70.5%) of the healthcare-acquired staphylococcal infections. Methicillin-resistant S. aureus was detected in 12 (85.7%) of 14 community-acquired staphylococcal infections. Eighty-three percent (n=10) of community-acquired MRSA infections were male and their mean age was 67.6 +/- 77.8 months (median 26, range 1-204). Sixty-seven percent (n=8) of healthcare-acquired MRSA (HAMRSA) were male and their mean age was 106.7 +/- 81.3 months (median 108, range 0-222). Most of the community-acquired MRSA patients were diagnosed with soft tissue infection. In the HA-MRSA cases, bacteraemia was the most common infection. Sixty-nine percent of the soft tissue infections originated from CA-MRSA, 73% of the other infections originating from HA-MRSA (p=0.041). MRSA associated mortality was not detected in the cases.CONCLUSIONS: Methicillin-resistant S. aureus (85.7%) was found to be high in community-acquired staphylococcal infections in our study. Most of the community-acquired MRSA was detected in patients with soft tissue infections, followed by septicemia. Bacteraemia was the most frequent healthcare-acquired MRSA infection.Publication Evaluation of micafungin use in children(Ankara Microbiology, 2020-01-01) Hacimustafaoglu, Mustafa; Yeşil, Edanur; YEŞİL, EDANUR; Çelebi, Solmaz; ÇELEBİ, SOLMAZ; Sezgin Evim, Melike; SEZGİN EVİM, MELİKE; Özer, Arife; Turan, Cansu; TURAN, CANSU; Timur, Demet; TİMUR, DEMET; Çakır, Salih Cağrı; ÇAKIR, SALİH ÇAĞRI; Bülbül, Beyhan; BÜLBÜL, BEYHAN; Ener, Beyza; ENER, BEYZA; Güneş, Adalet Meral; MERAL GÜNEŞ, ADALET; Koksal, Nilgun; Özkan, Hilal; ÖZKAN, HİLAL; Sevinir, Betul; SEVİNİR, BETÜL BERRİN; Düzcan Kilimci, Duygu; Tıp Fakültesi; Pediatri Onkoloji Ana Bilim Dalı; 0000-0002-8926-9959; 0000-0003-3146-6391; 0000-0001-5761-4757; 0000-0002-5720-1212; 0000-0002-3232-7652; 0000-0003-4646-660X; AAG-8523-2021; AEZ-2469-2022; GSO-3630-2022; AAH-1570-2021; HJZ-4508-2023; AAE-6201-2021; AAG-8393-2021; JCD-9679-2023Micafungin is recommended especially in patients with liver and kidney failure and in the presence of other side effects due to antifungals apart from its known priority indications such as invasive candidiasis. The aim of this study was to evaluate the children who have received micafungin treatment. In the study, 125 children who were hospitalized in the pediatric wards and intensive care units of our hospital and had used micafungin between November 2016 and January 2019 were analyzed retrospectively. Clinical data, micafungin indication, blood values on the first and fourth days of the treatment, side effects of the drug and efficacy were evaluated. Sixty percent (75/125) of the patients were male and the mean age of all the patients were 58 +/- 67 (0-215, 30) months. Approximately half of the cases (48%) had malignancy and 13% of them were premature. Sixty-two percent (n= 37) of the malignencies were hematological (27 acute lymphocytic leukemia, nine acute myeloid leukemia, one myelodysplastic syndrome) and 38% (n= 23) were oncological (six neuroblastoma, four Hodgkin lymphoma, two Non-Hodgkin's lymphoma, five sarcomas, one hepatoblastoma, five others) malignencies. The major cause of hospitalization was sepsis (53%). The patients had several risk factors like immunosuppressive therapy (n= 68, 54%), neutropenia (n= 61, 49%), central venous catheter (n= 102, 82%), nasogastric tube (n= 63, 50%), endotracheal intubation tube (n= 49, 39%), urinary catheter (n= 14, 11%) and total parenteral nutrition (n= 81, 65%). Thirteen percent (n= 16) of the cases were post-operative patients. Candida species were cultivated in 97 clinical specimens (blood, endotracheal aspirate, sputum, urine, etc.) among 23 (18%) of the patients. Thirteen (10%) of the patients had candidemia and 62% of them were non-albicans strains. In all candidemias, strains were echinocandin susceptible, and blood cultures were negative within four days. When all the patients (n= 125) were evaluated, a significant decrease in C-reactive protein, an increase in sodium, and a decrease in alanine aminotransferase were observed on the fourth day of micafungin treatment (p< 0.05). A total of 39 (31%) patients underwent various antifungal treatments for median seven (1-60) days prior to micafungin treatment. Fourteen (36%) of these 39 patients, had elevated liver function tests (LFT), 10 (26%) of them had hypokalemia, and five (13%) of them had elevated renal function tests. Ten (26%) patients had antifungal-induced hypokalemia previously; and potassium levels were normalized after micafungin treatment (p= 0.0001). The patients for which micafungin treatment was chosen due to elevated liver function tests (n= 47, 38%), whether the antifungalinduced or not; alanine aminotransferase and aspartate aminotransferase levels were decreased after micafungin treatment (p= 0.0001 and p= 0.0001, respectively). Nineteen (15%) of the patients have died within the first 30 days of micafungin treatment and one of them had candidemia. No micafungin treatment related significant side effects were observed in any of the patients. Our study showed that micafungin could be a safe and effective option in pediatric cases including newborns with high liver and kidney function tests.Publication Antibiotic associated diarrhea in outpatient pediatric antibiotic therapy(BMC, 2023-03-18) Başaranoğlu, Sevgen Tanir; Karaaslan, Ayşe; Sali, Enes; Çiftçi, Ergin; Aydın, Zeynep Gökçe Gayretli; Kocabaş, Bilge Aldemir; Kaya, Cemil; Bayturan, Semra Sen; Kara, Soner Sertan; Çiftdoğan, Dilek Yılmaz; Çay, Ümmühan; Aktürk, Hacer Gündoğdu; Çelik, Melda; Özdemir, Halil; Somer, Ayper; Diri, Tijen; Yazar, Ahmet Sami; Sütçü, Murat; Tezer, Hasan; Öncel, Eda Karadağ; Kara, Manolya; Celebi, Solmaz; Parlakay, Aslınur Özkaya; Karakaşlılar, Sabahat; Arısoy, Emin Sami; Tanir, Gönül; Kara, Tuğçe Tural; Devrim, İlker; Erat, Tuğba; Aykaç, Kubra; Kaba, Özge; Güven, Şirin; Yeşil, Edanur; Yılmaz, Ayşe Tekin; Durmuş, Sevgi Yaşar; Çaglar, İlknur; Gunay, Fatih; Özen, Metehan; Dinleyici, Ener Çağri; Kara, Ateş; ÇELEBİ, SOLMAZ; YEŞİL, EDANUR; Pediatri Enfekte Diş Hastalıkları Bölümü; 0000-0002-8926-9959; JHN-1091-2023; GSO-3630-2022BackgroundAntibiotic-associated diarrhea is one of the most frequent side effects of antimicrobial therapy. We assessed the epidemiological data of antibiotic-associated diarrhea in pediatric patients in our region.MethodsThe prospective multi-center study included pediatric patients who were initiated an oral antibiotic course in outpatient clinics and followed in a well-established surveillance system. This follow-up system constituded inclusion of patient by the primary physician, supply of family follow-up charts to the family, passing the demographics and clinical information of patient to the Primary Investigator Centre, and a close telephone follow-up of patients for a period of eight weeks by the Primary Investigator Centre.ResultsA result of 758 cases were recruited in the analysis which had a frequency of 10.4% antibiotic-associated diarrhea. Among the cases treated with amoxicillin-clavulanate 10.4%, and cephalosporins 14.4% presented with antibiotic-associated diarrhea. In the analysis of antibiotic-associated diarrhea occurrence according to different geographical regions of Turkey, antibiotic-associated diarrhea episodes differed significantly (p = 0.014), particularly higher in The Eastern Anatolia and Southeastern Anatolia. Though most commonly encountered with cephalosporin use, antibiotic-associated diarrhea is not a frequent side effect.ConclusionThis study on pediatric antibiotic-associated diarrhea displayed epidemiological data and the differences geographically in our region.Publication Evaluation of children with arthritis: 9 years retrospectif study(Galenos Yayınevi, 2020-08-01) Yeşil, Edanur; Çelebi, Solmaz; Özcan, Nur; Özer, Arife; Turan, Cansu; Bülbül, Beyhan; Ermutlu, Cenk; Sarısözen, Bartu; Hacımustafaoğlu, Mustafa; YEŞİL, EDANUR; ÇELEBİ, SOLMAZ; Özcan, Nur; Özer, Arife; TURAN, CANSU; BÜLBÜL, BEYHAN; ERMUTLU, CENK; SARISÖZEN, MEHMET BARTU; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Tıp Fakültesi; Ortopedi ve Travmatoloji Ana Bilim Dalı; Çocuk Enfeksiyon Bilim Dalı; 0000-0002-8926-9959; 0000-0003-3146-6391; 0000-0002-5720-1212; 0000-0003-4071-8052; 0000-0003-4646-660X; GSO-3630-2022; AEQ-5464-2022; JCD-9679-2023; ENK-4130-2022; JRU-9977-2023; DLB-3888-2022; IVB-4013-2023; GAX-3172-2022; ABI-7283-2020; CTG-5805-2022INTRODUCTION: The aim of this study was to evaluate the clinical and laboratory findings and treatment responses of patients with arthritis.MATERIALS and METHODS: The medical records of 111 children (0-18 years) were evaluated who were hospitalized with the diagnosis of arthritis between January 2010 and January 2019 retrospectively. The aim of this study was to evaluate the clinical and laboratory findings and to investigate the treatment and prognostic features of the patients.RESULTS: : A total of 111 patients, 66% were male and the mean age was 91+56 (median 83,1-215) months. The most of the patients (n=62,56%) were between 3-10 years of age. Septic arthritis was diagnosed in 60% (n=67) of the patients. This diagnosis was followed by reactive arthritis (10%), juvenile idiopathic arthritis (10%), toxic/transient synovitis (5%) and other arthritis. On admission, there were pain in 96%, joint swelling in 63%, redness in 21%, increased temperature of the joint in 41%, decreased range of motion in 64%, and inability to walk in 38% of the patients. The most frequently involved joints were knee (51%) and hip (35%). The possibility of septic arthritis was significantly higher in patients with high fever (p=0,0001). The response to ibuprofen was higher in non-septic arthritis (p=0,0001). Arthrocentesis was performed in 55% (n=61) of the cases and 34% (n=38) of the patients had underwent intra-articular debridement surgery. Staphylococcus aureus and Streptococcus pyogenes were the most common microorganisms growth in joint fluid culture. When septic arthritis and other arthritis cases were compared, the effusion amount, the amount of fluid taken by puncture were significantly higher and the level of CRP and leukocytes were higher in septic arthritis group (p=0,001;p=0,025;p=0,018;p=0,032,respectively). Osteomyelitis was observed in 19%(n=21) of the cases.CONCLUSIONS: In this study, the probability of septic arthritis was found to be statistically significant in patients with fever, leukocyte>12100/mm(3), CRP>3 mg/dl, and effusion measured 8.5 mm or more by ultrasonography. Also, ibuprofen response was higher in non-septic arthritis group.Publication Comparative evaluation of health care-related infections in pediatric and newborn intensive care units in a university hospital: The seven-year retrospective study(Galenos Yayınevi, 2021-08-01) Özaslan, Zeynep; Çelebi, Solmaz; Köksal, Nilgün; Özkan, Hilal; Ocakoğlu, Gökhan; Yeşil, Edanur; Özer, Arife; Turan, Cansu; Bülbül, Beyhan; Hacımustafaoğlu, Mustafa Kemal; ÖZASLAN, NEBAHAT ZEYNEP; ÇELEBİ, SOLMAZ; Köksal, Nilgün; ÖZKAN, HİLAL; OCAKOĞLU, GÖKHAN; YEŞİL, EDANUR; Özer, Arife; TURAN, CANSU; BÜLBÜL, BEYHAN; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Tıp Fakültesi; Biyoistatistik Ana Bilim Dalı; Çocuk Enfeksiyon Bilim Dalı; 0000-0001-9400-7825; 0000-0002-1114-6051; 0000-0002-8926-9959; 0000-0003-3146-6391; 0000-0002-5720-1212; 0000-0003-4646-660X; 0000-0003-2641-4140; 0000-0002-3536-0263; 0000-0001-5454-5119; 0000-0001-9232-0084; GSO-3630-2022; JCD-9679-2023; A-1302-2018; AAH-5180-2021; JHN-1091-2023; JGS-7600-2023; JJY-3921-2023; IVB-4013-2023; GAX-3172-2022; CTG-5805-2022; JHR-3083-2023Introduction: In this study, it was aimed to evaluate the incidence, density and reciprocal relationships of Health Care Associated Infections (HCAIs) detected in the Pediatric Intensive Care Unit (PICU) and Neonatal Intensive Care Unit (NICU) in Bursa Uludag University Faculty of Medicine Hospital as a general perspective.Materials and Methods: In this study, data of 91 PICU and 158 NICU patients who developed HCAIs between 2012-2018 years, taking into account the criteria of the Centers for Disease Control and Prevention (CDC) 2015 and the Turkish National Hospital Infections Surveillance Network (UHESA) 2017, were retrospectively analyzed.Results: The HCAIs rate was higher in NICU (9.6% vs 14.9%; respectively, p <0.001), but the infection density was lower (9.9 versus 7.8/1000 patient days, p=0.061). Stay of length for all patients in NICU was found to be longer (19.1 days vs 9.7 days; p <0.001), and the median length of stay with HCAIs in PICU and in NICU was 41.5 days versus 49 days respectively (p=0.1). The median time of HCAIs diagnosis was 17 days in PICU vs 15 days in NICU, p=0.6). In NICU, according to birth weight, HCAIs rates and infection densities were 7.8% and 2.7/1000 patient-days in <750 g patients; 23.2% and 6.2/1000 patient-days in 751-1000 g patients, 6.1% and 4.9 patient-days in 1001-1500 g patients, 44.7% and 9.2/1000 patient-days in 1501-2500 g patients, and %24.6 and 13.8/1000 patient-days in >2501 g patients. HCAIs rates were found to be higher in babies with >1501 g.Conclusions: There may be differences in the rates and prevention strategies in PICU and NICU and continuous and high quality maintenance is important for infection control measures.Publication Anesthesia/surgery and vaccination(Aves Yayincilik, Ibrahim Kara, 2019-12-01) Yeşil, Edanur; YEŞİL, EDANUR; Hacımustafaoğlu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Tıp Fakültesi; Pediatri Ana Bilim Dalı; 0000-0002-8926-9959; 0000-0003-4646-660X; GSO-3630-2022Publication Results of the use of micafungin in newborns(Ankara Microbiology Soc, 2019-01-01) Çakır, Salih Çağrı; ÇAKIR, SALİH ÇAĞRI; Çelebi, Solmaz; ÇELEBİ, SOLMAZ; Özkan, Hilal; ÖZKAN, HİLAL; Köksal, Nilgün; Dorum, Bayram Ali; Yeşil, Edanur; YEŞİL, EDANUR; Hacımustafaoğlu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Tıp Fakültesi; Nefroloji Ana Bilim Dalı; 0000-0001-5761-4757; 0000-0002-2823-8454; 0000-0002-8926-9959; 0000-0003-4646-660X; AAG-8393-2021; AEZ-2469-2022; GSO-3630-2022; HJZ-4508-2023; A-5375-2017; JCD-9679-2023Invasive candidiasis is a common and serious infection in premature newborns. Preventing and treating fungal infections is very important to improve the prognosis of premature infants. Fluconazole and amphotericin B are used as the first choice in the treatment of invasive fungal infections of the newborns. In some cases, fluconazole and amphotericin B cannot be used due to nephrotoxicity, hepatotoxicity or resistant strains. Micafungin, which is among recently developed echinocandins, is the drug of choice in these cases. The use of micafungin in newborns is new and there is a limited experience about the effect of high dose usage in the central nervous system. The aim of this study was to evaluate the electronic files of patients who used micafungin for the treatment of culture-proven or possible invasive fungal infection during their hospital stay in the neonatal intensive care unit during a 24-month period (2016-2017) in the third-level intensive care unit. A total of 15 patients (10 premature and 5 term babies) were included in the study. The mean birth weight of the patients was 1732 +/- 999 g and the mean gestational age was 32.2 +/- 5.8 weeks. All patients had long-term intensive care and increased risk of invasive candidiasis infection. Central venous catheterization and multiple antibiotics usage were the most common risk factors in these patients. The other risk factors included intubation, total parenteral nutritional use and surgical procedure application. Candida species were isolated from the cultures of four patients. Candida species isolated from patients were Candida albicans, Candida glabrata, Candida catenulata, Candida parapsilosis. The mean time for onset of micafungin was 29.9 +/- 16.6 days. Mean duration of micafungin therapy was 22.4 +/- 11.2 days. Eight patients received amphotericin B, three patients received fluconazole therapy and four patients did not receive any antifungal therapy before the onset of micafungin. None of these patients had an abnormal kidney or liver function tests due to micafungin use. As a conclusion, high dose (10 mg/kg/day) micafungin is a safe and effective treatment choice both in the treatment of neonatal culture proven or probable invasive candida infections that were caused by refractory Candida strains, and in the case of nephrotoxicity and hepatotoxicity.Publication Novel coronavirus 2019 infections current status(Galenos Publ House, 2020-04-01) Yeşil, Edanur; YEŞİL, EDANUR; Hacımustafaoğlu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Tıp Fakültesi; Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı; 0000-0002-8926-9959; 0000-0003-4646-660X; GSO-3630-2022; JCD-9679-2023Coronaviruses are enveloped RNA viruses that take their name from the thorny protrusions (Corona; Crown) on their surface in electron microscopy.They can cause respiratory,enteric,hepatic, and neurological diseases in humans and animals.Human infections are usually caused by Alpha and Beta types. Human Coronaviruses (HCoV) were first described in the 1960s,and these are mainly 229E,NL63,OC43 and HKU1 Coronaviruses, causing typical mild/moderate respiratory diseases in humans.In addition,occasional outbreaks of different severe Coronavirus infections (MERS-CoV,SARS-CoV) have been reported.Apart from these,new(novel) Coronavirus infections (2019-nCoV, SARS-CoV-2 or COVID-19) have been reported which started in Wuhan,Hubei,China in December 2019 and tend to spread all over the world.In this review,it is aimed to present the epidemiological course,genetic factors,transmission,prevention of this novel Coronavirus infections with the clinical findings in adults and children,diagnosis,treatment,prevention methods and current information in our country.As of February 12,2020, 45.171 proven cases have been reported in the world and 25 different countries have been affected by this epidemic.The average incubation period of COVID-19 infection was 5.2days (1-14 days).The fatality rate was 2.5% on average in all cases,but 4.3-15% in severe or hospitalized patients.In adult cases,it begins clinically with nonspecific upper respiratory tract infections such as fever,cough and weakness.In severe cases,symptoms such as pneumonia and severe respiratory failure develop within days.In laboratory findings;lymphopenia was observed in hospitalized patients,lung involvement was in almost all cases with bilateral and multilobuler and/or subsegmental consolidation. Pediatric cases were usually asymptomatic or with mild upper respiratory tract infection findings. Pneumonia has been rarely seen.Mortality has not been reported in pediatric cases.Treatment of COVID-19 mainly consists of supportive therapy. Droplet isolation measures and hand hygiene play an important role in protection.Rigorous application of infection control measures is expected to be helpful in breaking the epidemics and pandemics.