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    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; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim 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-5805-2022
    INTRODUCTION: 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.
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    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; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Onkoloji Anabilim 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-9679-2023
    Micafungin 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.
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    Education of healthcare personnel working with pediatric patients during covid-19 pandemic within the framework of infection control
    (Aves Yayıncılık, 2020-11-28) Oygar, Pembe Derin; Büyükcam, Ayşe; Bal, Zümrüt Şahbudak; Dalgıc, Nazan; Bozdemir, Sefika Elmas; Karbuz, Adem; Çetin, Benhur 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 Ocal; 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; Karaarslan, Ayşe; Bülbül, Lida; Almış, Habip; Kaba, Özge; Keles, Yıldız Ekemen; Yazıcıoğlu, Bahadir; 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; Turgut, Mehmet; Yanartaş, Mehpare Sarı; Şahin, Aslıhan; Arslanoğlu, Sertaç; Elevli, Murat; Öz, Sadiye Kübra Tuter; Hatipoğlu, Halil; Erkum, İlyas Tolga; Demirbuğa, Asuman; Özçelik, Taha; Sarı, Emine Ergül; Akkuş, Gökhan; Hatipoğlu, Sadık Sami; Dinleyici, Ener Cağrı; Hacımustafaoğlu, Mustafa; Özkinay, Ferda; Kuruğol, Zafer; Cengiz, Ali Bülent; Somer, Ayper; Tezer, Hasan; Kara, Ateş; ÇELEBİ, SOLMAZ; TURAN, CANSU; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Hastalıkları Bilim Dalı.; IVB-4013-2023; JHN-1091-2023; CTG-5805-2022
    Objective: In the early stages of any epidemic caused by new emerging pathogens healthcare personnel is subject to a great risk. Pandemic caused by SARS-CoV-2, proved to be no exception. Many healthcare workers died in the early stages of pandemic due to inadequate precautions and insufficient protection. It is essential to protect and maintain the safety of healthcare personnel for the confinement of pandemic as well as continuity of qualified healthcare services which is already under strain. Educating healthcare personnel on appropiate use of personal protective equipment (PPE) is as essential as procuring them.Material and Methods: A survey is conducted on 4927 healthcare personnel working solely with pediatric patients from 32 different centers. Education given on PPE usage were questioned and analyzed depending on age, sex, occupation and region.Results: Among four thousand nine hundred twelve healthcare personnel from 32 different centers 91% (n=4457) received education on PPE usage. Of those who received education only 36% was given both theoretical and applied education. Although there was no differences among different occupation groups, receiving education depended on regions.Conclusion: It is essential to educate healthcare personnel appropiately nationwidely for the continuity of qualified healthcare services during the pandemic.
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    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; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Neonotoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim 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-3083-2023
    Introduction: 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.
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    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.