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Yılmaz D, Üstündağ G, Büyükçam A, Salı E, Çelik Ü, Avcu G, Belet N, Çakmak Taşkın E, Öcal Demir S, Birbilen AZ, Kılıç Ö, Metin Akcan Ö, Tekin Yılmaz A, Aldemir Kocabaş B, Hatipoğlu N, Karbuz A, Çakır D, Sütçü M, Aygün FD, Çelik T, Bayturan Şen S, Dalgıç N, Ümit Z, Kara SS, Karadağ Öncel E, Bolat A, Kılıç Çil M, Turan C, Çakıl Güzin A, Topal S, Esen Besli G, Doğan G, Şahin S, Akın F, Bildirici Y, Timurtaş Dayar G, Ergül Sarı E, Kızmaz İşançlı D, Kara M, Önal P, Aylaç H, Lüleci D, Yaşar B, Dede E, Çağlar A, Akova S, Afat Turgut E, Yazıcı Özkaya P, Kandemir Gülmez T, Ulusoy E, Duyu M, Kara Y, Çeliktaş H, Tekeli O, Çağlar F, Gül D, Oral Cebeci S, Battal F, Bal A, Aygün E, Uysalol M, Arslan G, Özkavaklı A, Kızıl MC, Yazar A, Aygün F, Somer A, Kuyucu N, Dinleyici EÇ, Kara A. A snapshot of pediatric inpatients and outpatients with COVID-19: a point prevalence study from Turkey. Eur J Pediatr 2023:10.1007/s00431-023-04982-6. [PMID: 37140703 PMCID: PMC10157577 DOI: 10.1007/s00431-023-04982-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/31/2023] [Accepted: 04/13/2023] [Indexed: 05/05/2023]
Abstract
This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs (p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations (p = 0.001, p = 0.012, and p = 0.027). Conclusion: To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children.
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Affiliation(s)
- Dilek Yılmaz
- Department of Pediatric Infectious Diseases, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Turkey
| | - Gülnihan Üstündağ
- Pediatric Infectious Disease Clinic, Health Science University İzmir Tepecik Training and Research Hospital, Konak 35020, İzmir, Turkey.
| | - Ayşe Büyükçam
- Pediatric Infectious Disease Clinic, Health Science University Gülhane Training and Research Hospital, Ankara, Turkey
| | - Enes Salı
- Pediatric Infectious Disease Clinic, Health Science University Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Ümit Çelik
- Pediatric Infectious Disease Clinic, Adana City Hospital, Adana, Turkey
| | - Gülhadiye Avcu
- Department of Pediatric Infectious Diseases, Ege University Faculty of Medicine, İzmir, Turkey
| | - Nurşen Belet
- Department of Pediatric Infectious Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Esra Çakmak Taşkın
- Pediatric Infectious Disease Clinic, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Sevliya Öcal Demir
- Pediatric Infectious Disease Clinic, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ahmet Ziya Birbilen
- Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital, Pediatric Emergency Clinic, Gaziantep, Turkey
| | - Ömer Kılıç
- Department of Pediatric Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Özge Metin Akcan
- Department of Pediatric Infectious Diseases, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Ayşe Tekin Yılmaz
- Pediatric Infectious Disease Clinic, Eskişehir City Hospital, Eskişehir, Turkey
| | - Bilge Aldemir Kocabaş
- Pediatric Infectious Disease Clinic, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Nevin Hatipoğlu
- Pediatric Infectious Disease Clinic, Health Science University İstanbul Bakırköy Doctor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Adem Karbuz
- Pediatric Infectious Disease Clinic, Cemil Taşçıoğlu City Hospital, İstanbul Prof. Dr, Istanbul, Turkey
| | - Deniz Çakır
- Pediatric Infectious Disease Clinic, Health Science University Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Murat Sütçü
- Department of Pediatric Infectious Diseases, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Fatma Deniz Aygün
- Department of Pediatric Infectious Diseases, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Taylan Çelik
- Department of Pediatric Infectious Diseases, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Semra Bayturan Şen
- Department of Pediatric Infectious Diseases, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Nazan Dalgıç
- Pediatric Infectious Disease Clinic, Health Science University Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Zühal Ümit
- Pediatric Infectious Disease Clinic, Manisa City Hospital, Manisa, Turkey
| | - Soner Sertan Kara
- Department of Pediatric Infectious Diseases, Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Eda Karadağ Öncel
- Pediatric Infectious Disease Clinic, Health Science University İzmir Tepecik Training and Research Hospital, Konak 35020, İzmir, Turkey
| | - Ahmet Bolat
- Pediatrics Clinic, Health Science University Gülhane Training and Research Hospital, Ankara, Turkey
| | - Merve Kılıç Çil
- Pediatric Infectious Disease Clinic, Adana City Hospital, Adana, Turkey
| | - Caner Turan
- Department of Pediatric Emergency Medicine, Ege University Faculty of Medicine, İzmir, Turkey
| | - Ayşe Çakıl Güzin
- Department of Pediatric Infectious Diseases, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Sevgi Topal
- Pediatric Intensive Care Unit, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Gülser Esen Besli
- Pediatric Emergency Clinic, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Gizem Doğan
- Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital, Pediatrics Clinic, Gaziantep, Turkey
| | - Sabiha Şahin
- Department of Pediatric Emergency Medicine, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Fatih Akın
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Yaşar Bildirici
- Pediatrics Clinic, Eskişehir City Hospital, Eskişehir, Turkey
| | - Gülperi Timurtaş Dayar
- Pediatric Infectious Disease Clinic, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Emine Ergül Sarı
- Pediatrics Clinic, Health Science University İstanbul Bakırköy Doctor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Didem Kızmaz İşançlı
- Pediatric Infectious Disease Clinic, Cemil Taşçıoğlu City Hospital, İstanbul Prof. Dr, Istanbul, Turkey
| | - Manolya Kara
- Department of Pediatric Infectious Diseases, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Pınar Önal
- Department of Pediatric Infectious Diseases, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Hakan Aylaç
- Department of Pediatrics, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Duygu Lüleci
- Department of Pediatrics, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Belma Yaşar
- Pediatric Infectious Disease Clinic, Health Science University Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Elif Dede
- Department of Pediatric Infectious Diseases, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Aykut Çağlar
- Department of Pediatric Emergency Medicine , Adnan Menderes University Faculty of Medicine, Aydın, Turkey
| | - Sevgi Akova
- Pediatric Emergency Clinic, Health Science University Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Elif Afat Turgut
- Pediatric Infectious Disease Clinic, Adana City Hospital, Adana, Turkey
| | - Pınar Yazıcı Özkaya
- Department of Pediatric Intensive Care, Ege University Faculty of Medicine, İzmir, Turkey
| | | | - Emel Ulusoy
- Department of Pediatric Emergency Medicine, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Muhterem Duyu
- Pediatric Intensive Care Unit, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Yalçın Kara
- Department of Pediatric Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Hüseyin Çeliktaş
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Onur Tekeli
- Pediatric Infectious Disease Clinic, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Fatma Çağlar
- Pediatric Emergency Clinic, Health Science University İstanbul Bakırköy Doctor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Doruk Gül
- Department of Pediatrics, İstinye University Faculty of Medicine, Istanbul, Turkey
| | - Sinem Oral Cebeci
- Department of Pediatric Emergency Medicine, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Fatih Battal
- Department of Pediatrics, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Alkan Bal
- Department of Pediatric Emergency Medicine, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Emre Aygün
- Pediatrics Clinic, Health Science University Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Metin Uysalol
- Department of Pediatric Emergency Medicine, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Gazi Arslan
- Department of Pediatric Intensive Care, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Ayberk Özkavaklı
- Pediatrics Clinic, Medeniyet University Göztepe Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Mahmut Can Kızıl
- Department of Pediatric Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Abdullah Yazar
- Department of Pediatrics, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Fatih Aygün
- Department of Pediatric Intensive Care, Cerrahpaşa University Faculty of Medicine, Istanbul, Turkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseases, İstanbul University Faculty of Medicine, Istanbul, Turkey
| | - Necdet Kuyucu
- Department of Pediatric Infectious Diseases, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Ener Çağrı Dinleyici
- Department of Pediatric Intensive Care, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Ateş Kara
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Tanır Basaranoğlu S, Karaaslan A, Salı E, Çiftçi E, Gayretli Aydın ZG, Aldemir Kocabaş B, Kaya C, Şen Bayturan S, Kara SS, Yılmaz Çiftdoğan D, Çay Ü, Gundogdu Aktürk H, Çelik M, Ozdemir H, Somer A, Diri T, Yazar AS, Sütçü M, Tezer H, Karadag Oncel E, Kara M, Çelebi S, Özkaya Parlakay A, Karakaşlılar S, Arısoy ES, Tanır G, Tural Kara T, Devrim İ, Erat T, Aykaç K, Kaba Ö, Güven Ş, Yeşil E, Tekin Yılmaz A, Yaşar Durmuş S, Çağlar İ, Günay F, Özen M, Dinleyici EÇ, Kara A. Antibiotic associated diarrhea in outpatient pediatric antibiotic therapy. BMC Pediatr 2023; 23:121. [PMID: 36932373 PMCID: PMC10024443 DOI: 10.1186/s12887-023-03939-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/02/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Antibiotic-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. METHODS The 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. RESULTS A 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. CONCLUSION This study on pediatric antibiotic-associated diarrhea displayed epidemiological data and the differences geographically in our region.
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Affiliation(s)
- Sevgen Tanır Basaranoğlu
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, 06100, Turkey
| | - Ayşe Karaaslan
- Department of Pediatric Infectious Diseases, Istanbul Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Enes Salı
- Department of Pediatric Infectious Diseases, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
| | - Ergin Çiftçi
- Department of Pediatric Infectious Diseases, Ankara University, Ankara, Turkey
| | | | - Bilge Aldemir Kocabaş
- Department of Pediatric Infectious Diseases, Antalya Akdeniz University, Antalya, Turkey
| | - Cemil Kaya
- Department of Pediatrics, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
| | - Semra Şen Bayturan
- Department of Pediatric Infectious Diseases, Manisa Celal Bayar University, Manisa, Turkey
| | - Soner Sertan Kara
- Department of Pediatric Infectious Diseases, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Dilek Yılmaz Çiftdoğan
- Department of Pediatric Infectious Diseases, Saglik Bilimleri University, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ümmühan Çay
- Department of Pediatric Infectious Diseases, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Hacer Gundogdu Aktürk
- Department of Pediatric Infectious Diseases, Istanbul Zeynep Kamil Women and Children Training and Research Hospital, Istanbul, Turkey
| | - Melda Çelik
- Department of Pediatric Infectious Diseases, Ankara Kecioren Training and Research Hospital, Ankara, Turkey
| | - Halil Ozdemir
- Department of Pediatric Infectious Diseases, Ankara University, Ankara, Turkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseases, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Tijen Diri
- Department of Pediatrics, Istanbul Acıbadem Atakent Hospital, Istanbul, Turkey
| | - Ahmet Sami Yazar
- Department of Pediatrics, Istanbul Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Murat Sütçü
- Department of Pediatric Infectious Diseases, Konya Training and Research Hospital, Konya, Turkey
| | - Hasan Tezer
- Department of Pediatric Infectious Diseases, Ankara Gazi University, Ankara, Turkey
| | - Eda Karadag Oncel
- Department of Pediatric Infectious Diseases, Saglik Bilimleri University, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Manolya Kara
- Department of Pediatric Infectious Diseases, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Solmaz Çelebi
- Department of Pediatric Infectious Diseases, Bursa Uludag University, Bursa, Turkey
| | - Aslınur Özkaya Parlakay
- Department of Pediatric Infectious Diseases, Ankara Yildirim Beyazit University, Ankara, Turkey
| | | | - Emin Sami Arısoy
- Department of Pediatric Infectious Diseases, Kocaeli University, Kocaeli, Turkey
| | - Gönül Tanır
- Department of Pediatric Infectious Diseases, Ankara Doktor Sami Ulus Women and Children Training and Research Hospital, Ankara, Turkey
| | - Tuğçe Tural Kara
- Department of Pediatric Infectious Diseases, Hatay State Hospital, Hatay, Turkey
| | - İlker Devrim
- Department of Pediatric Infectious Diseases, Izmir Doktor Behcet Uz Children's Hospital, İzmir, Turkey
| | - Tuğba Erat
- Department of Pediatric Infectious Diseases, Ankara University, Ankara, Turkey
| | - Kübra Aykaç
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, 06100, Turkey
| | - Özge Kaba
- Department of Pediatric Infectious Diseases, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Şirin Güven
- Department of Pediatrics, Istanbul Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Edanur Yeşil
- Department of Pediatric Infectious Diseases, Bursa Uludag University, Bursa, Turkey
| | - Ayşe Tekin Yılmaz
- Department of Pediatric Infectious Diseases, Kocaeli University, Kocaeli, Turkey
| | - Sevgi Yaşar Durmuş
- Department of Pediatric Infectious Diseases, Ankara Doktor Sami Ulus Women and Children Training and Research Hospital, Ankara, Turkey
| | - İlknur Çağlar
- Department of Pediatric Infectious Diseases, Izmir Doktor Behcet Uz Children's Hospital, İzmir, Turkey
| | - Fatih Günay
- Department of Pediatrics, Ankara University, Ankara, Turkey
| | - Metehan Özen
- Department of Pediatric Infectious Diseases, Istanbul Acıbadem Atakent Hospital, Istanbul, Turkey
| | | | - Ateş Kara
- Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine, Ankara, 06100, Turkey.
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Kara Y, Kızıl MC, Kılıç Ö, Us T, Dinleyici EÇ. Investigation of the use of multiplex PCR in childhood diarrhea with clinical and epidemiological features. J Trop Pediatr 2022; 68:6770065. [PMID: 36272732 DOI: 10.1093/tropej/fmac090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Acute gastroenteritis is one of the most common causes of hospital admission in children. Treatment regimens differ depending on the pathogen. In our study, we aimed to evaluate the epidemiological and clinical features of pediatric patients whose gastrointestinal agents were detected by multiplex PCR. MATERIALS AND METHODS The study included 131 pediatric patients who were followed up at Eskişehir Osmangazi University, Pediatric Department between January 2018 and December 2021.Gastrointestinal pathogens were detected in stool samples by multiplex PCR. The epidemiological and clinical features were reviewed retrospectively. RESULTS A total of 203 gastrointestinal pathogens were detected from the stool samples of 131 cases. Of these cases, 56% were male and 44% were female. The mean age was 66 (2-204) months. The most common symptoms were diarrhea, fever, vomiting and abdominal pain. The pathogen detection rate was 69% by multiplex PCR. A single pathogen was detected in 85 (65%) cases and multiple pathogens were detected in 46 (35%) cases. The most common pathogens were enteropathogenic Escherichia coli (EPEC, 23%), Clostridium difficile (21%), norovirus (17%), rotavirus (15%), salmonella (12%) and enterotoxigenic E. coli (ETEC, 11%). Stool culture was positive in 16 (12%) cases and microscopic examination positive in 17 (13%) cases. Probiotic treatment was given to 119 (92%) cases and antimicrobial treatment (metroinidazole, ceftriaxone, azithromycin and oral vancomycin) to 34 (26%) cases. Of the cases, 56 (42%) had chronic disease, 40 (30%) had a history of previous antibiotic use and 17 (13%) had a history of hospitalization in the intensive care unit. CONCLUSION The sensitivity of the multiplex PCR in the detection of acute gastroenteritis agents is higher than stool microscopy, stool culture and stool antigen tests. However, due to the inability to distinguish between colonization, carrier state and pathogenicity, it should be evaluated together with other diagnostic tests and clinical findings in order to determine whether the determined agent is pathogenic or not and in the regulation of antimicrobial therapy.
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Affiliation(s)
- Yalçın Kara
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey
| | - Mahmut Can Kızıl
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey
| | - Ömer Kılıç
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey
| | - Tercan Us
- Department of Microbiology, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey
| | - Ener Çağrı Dinleyici
- Division of Pediatric Intensive Care Unit, Department of Pediatrics, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey
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İşeri Nepesov M, Kılıç Ö, Dinleyici EÇ. Successful intraventricular colistin treatment in resistant Klebsiella pneumoniae meningitis. J Infect Dev Ctries 2022; 16:1226-1229. [PMID: 35905029 DOI: 10.3855/jidc.14096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 04/30/2021] [Indexed: 10/31/2022] Open
Abstract
Meningitis due to resistant microorganisms after neurosurgical intervention progresses with significant morbidity and mortality. Treatment is difficult as the antibiotics available for this purpose as well as their transition to the cerebrospinal fluid are limited. Due to the inability of the intravenously administered colistin to cross the blood-brain barrier sufficiently, intraventricular colistin application is recommended in the treatment of meningitis. Herein we report successful treatment with intraventricular colistin of an infant with ventriculoperitoneal shunt-related meningitis due to extended spectrum β-lactamase-producing Klebsiella pneumoniae. The infant lacked clinical response despite effective intravenous antibiotic therapy. Intrathecal/intraventricular colistin can be an effective alternative in the treatment of resistant Gram-negative bacilli meningitis.
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Affiliation(s)
- Merve İşeri Nepesov
- Department of Pediatrics, Division of Pediatric Infectious Disease, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey.
| | - Ömer Kılıç
- Department of Pediatrics, Division of Pediatric Infectious Disease, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Ener Çağrı Dinleyici
- Department of Pediatrics, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
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Aslan K, Kiliç Ö, Kiral E, Bozan G, Bör Ö, Dinleyici EÇ. Clinical and laboratory responses to tigecycline in children. J Clin Pharm Ther 2022; 47:1585-1590. [DOI: 10.1111/jcpt.13708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/13/2022] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Kaan Aslan
- Department of Pediatrics Eskişehir Osmangazi University Medical Faculty Eskişehir Turkey
| | - Ömer Kiliç
- Division of Pediatric Infectious Diseases Eskişehir Osmangazi University Medical Faculty Eskişehir Turkey
| | - Eylem Kiral
- Division of Pediatric Intensive Care Unit Eskişehir Osmangazi University Medical Faculty Eskişehir Turkey
| | - Gürkan Bozan
- Division of Pediatric Intensive Care Unit Eskişehir Osmangazi University Medical Faculty Eskişehir Turkey
| | - Özcan Bör
- Division of Pediatric Hematology‐Oncology Eskişehir Osmangazi University Medical Faculty Eskişehir Turkey
| | - Ener Çağrı Dinleyici
- Division of Pediatric Intensive Care Unit Eskişehir Osmangazi University Medical Faculty Eskişehir Turkey
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İşeri Nepesov M, Kılıç Ö, Günay C, Çalışır C, Çağrı Dinleyici E. Brodie Abscess in a Previously Healthy Boy. J Pediatr Inf 2021. [DOI: 10.5578/ced.20219723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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İşeri Nepesov M, Kılıç Ö, Günay C, Çalışır C, Dinleyici EÇ. Brodie Abscess in a Previously Healthy Boy. J Pediatr Inf 2021. [DOI: 10.5578/ced.20219708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Oygar PD, Büyükçam A, Bal ZŞ, Dalgıç N, Bozdemir ŞE, Karbuz A, Çetin BŞ, Kara Y, Çetin C, Hatipoğlu N, Uygun H, Aygün FD, Törün SH, Okur DŞ, Çiftdoğan DY, Kara TT, Yahşi A, Özer A, Demir SÖ, Akkoç G, Turan C, Salı E, Şen S, Erdeniz EH, Kara SS, Emiroğlu M, Erat T, Aktürk H, Gürlevik SL, Sütçü M, Aydın ZGG, Atikan BY, Yeşil E, Güner G, Çelebi E, Efe K, İşançlı DK, Durmuş HS, Tekeli S, Karaaslan A, Bülbül L, Almış H, Kaba Ö, Keleş YE, Yazıcıoğlu B, Oğuz ŞB, Ovalı HF, Doğan HH, Çelebi S, Çakır D, Karasulu B, Alkan G, Yenidoğan İ, Gül D, Küçükalioğlu BP, Avcu G, Kukul MG, Bilen M, Yaşar B, Üstün T, Kılıç Ö, Akın Y, Cebeci SO, Bucak IH, Yanartaş MS, Şahin A, Arslanoğlu S, Elevli M, Çoban R, Öz ŞKT, Hatipoğlu H, Erkum İT, Turgut M, Demirbuğa A, Özçelik T, Çiftçi D, Sarı EE, Akkuş G, Hatipoğlu SS, Dinleyici EÇ, Hacımustafaoğlu M, Özkınay F, Kurugöl Z, Cengiz AB, Somer A, Tezer H, Kara A. SARS-CoV-2 seropositivity among pediatric health care personnel after the first peak of the pandemic: nationwide surveillance in Turkey. Int J Infect Dis 2021; 113:184-189. [PMID: 34592441 PMCID: PMC8474801 DOI: 10.1016/j.ijid.2021.09.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/31/2021] [Accepted: 09/22/2021] [Indexed: 11/19/2022] Open
Abstract
Background Understanding SARS-CoV-2 seroprevalence among health care personnel is important to explore 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.
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İşeri Nepesov M, Kıral E, Bozan G, Kılıç Ö, Çarman KB, Yarar C, Şaylısoy S, Dinleyici EÇ. Brain Abscess in a Patient with Osteopetrosis: A Rare Complication. J Clin Res Pediatr Endocrinol 2021; 13:358-361. [PMID: 32840095 PMCID: PMC8388059 DOI: 10.4274/jcrpe.galenos.2020.2020.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Brain abscess formation is extremely rare in patients with osteopetrosis. Herein, we report a case of viridans streptococci brain abscess in an immunocompromised child diagnosed with osteopetrosis. The patient presented with a sudden change in mental status and convulsions. Radiological evaluation revealed a temporal lobe brain abscess, and intravenous antibiotherapy was started immediately. The patient underwent abscess drainage, and laboratory investigation of pus material revealed viridans streptococci.
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Affiliation(s)
- Merve İşeri Nepesov
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Infectious Diseases, Eskişehir, Turkey
| | - Eylem Kıral
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Intensive Care Unit, Eskişehir, Turkey
| | - Gürkan Bozan
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Intensive Care Unit, Eskişehir, Turkey
| | - Ömer Kılıç
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Infectious Diseases, Eskişehir, Turkey,* Address for Correspondence: Division of Pediatric Infectious Diseases, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey Phone: +90 222 239 29 79 E-mail:
| | - Kürşat Bora Çarman
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Neurology, Eskişehir, Turkey
| | - Coşkun Yarar
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Neurology, Eskişehir, Turkey
| | - Suzan Şaylısoy
- Eskişehir Osmangazi University Faculty of Medicine, Department of Radiology, Eskişehir, Turkey
| | - Ener Çağrı Dinleyici
- Eskişehir Osmangazi University Faculty of Medicine, Department of Pediatric Intensive Care Unit, Eskişehir, Turkey
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10
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Çarman KB, Karal Y, Mert GG, Ekici A, Perk P, Arslantaş D, Yarar C, Dinleyici EÇ. Expression of MicroRNA 146a, 155, 181 and 223 in febrile seizure. Turk J Pediatr 2021; 63:594-601. [PMID: 34449141 DOI: 10.24953/turkjped.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND We studied microRNAs (miRNAs) -146a, -155, -181 and -223 expressions and proinflammatory cytokine levels in children with Febrile seizure (FS) and compared to febrile controls. METHODS This prospective multicenter study examined representative populations in eight different cities in Turkey between June 30, 2018 and July 1, 2019. Blood samples were taken from all children at presentation. The real time (RT) polymerase chain reaction (PCR) were used to measure the expressions of microRNAs and tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin 6 (IL-6) levels were studied by enzyme-linked immuno-sorbent assay. RESULTS The study was conducted with 60 children; 30 children with FS and 30 children in the febrile control group. The seizure was classified as simple FS in 73.3 % and half of the children were experiencing their first FS episode. Although the expression levels of miRNAs-146a, -181a and -155 were higher in febrile seizure patients, only miRNAs 146a level was significantly higher in FS patients. Serum TNF-α, IL-1β, IL-6 levels were higher in the FS group than the controls. The results of statistical analysis showed that there were correlations within miRNA expressions in children with FS. No differences were found considering miRNA expression between FS type, number of FS experienced. CONCLUSIONS miRNAs-146a, -181a, -155 and -223 may be involved in FS pathogenesis. Altered miRNA expression levels might be an adaptive response to inflammation. New therapeutic approaches might be developed based on miRNA expressions in children with FS.
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Affiliation(s)
- Kürşat Bora Çarman
- Division of Pediatric Neurology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir
| | - Yasemin Karal
- Department of Pediatrics, Trakya University Faculty of Medicine, Edirne
| | - Gül Gülen Mert
- Department of Pediatric Neurology, Çukurova University Faculty of Medicine, Adana
| | - Arzu Ekici
- Department of Pediatric Neurology, Yüksek İhtisas Hospital, Bursa
| | - Peren Perk
- Gaziantep Children's Hospital, Gaziantep
| | - Didem Arslantaş
- Departments of Public Health and Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Coskun Yarar
- Division of Pediatric Neurology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir
| | - Ener Çağrı Dinleyici
- Departments of Pediatrics, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
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11
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Kılıç Ö, İşeri Nepesov M, Ulukapı HB, Özdemir ZC, Bör Ö, Dinleyici EÇ. Paediatric Agranulocytosis Associated with Metamizole Treatment. Paediatr Drugs 2021; 23:105-110. [PMID: 33247375 DOI: 10.1007/s40272-020-00431-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Metamizole, which has antipyretic and pain-relieving properties, is generally used to treat fever in children who do not respond to paracetamol treatment. The most remarkable side effect of metamizole is that it causes myelotoxicity independently of dose. In this study, we aimed to present the clinical features of paediatric patients who developed agranulocytosis after the use of metamizole and draw attention to this side effect. METHODS The patients who were admitted to Eskişehir Osmangazi University Faculty of Medicine Hospital, Pediatric Infectious Diseases and Pediatric Hematology Service, between January 1, 2015, and December 31, 2018, with a diagnosis of secondary agranulocytosis to metamizole use were examined retrospectively. RESULTS In all, 12 patients were included in the study; oral metamizole was used in these patients for fever reduction. The mean absolute neutrophil count was 225/mm3 ± 226 (0-600/mm3) at admission, and the neutrophil value of 11 patients was < 500/mm3. The mean length of hospitalisation of the patients was 9.92 ± 8 (3-28) days. Eight patients received intravenous antibiotic therapy and four patients received at least one of the following treatments: intravenous immunoglobulin, granulocyte colony-stimulating factor and methylprednisolone. Bone marrow aspiration examination showed neutrophil/band maturation delaying in the myeloid series with normocellular bone marrow in three patients. Hypocellularity in the bone marrow and decrease in myeloid precursors were observed in three patients. There were no fatal cases. CONCLUSION The development of agranulocytosis after the use of metamizole causes long-term hospitalisation and may require the use of medications in treatment management. Considering the availability of alternative options to treat fever and pain, and given the side-effect profile of metamizole, it should not be the preferred, first-line antipyretic treatment in children.
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Affiliation(s)
- Ömer Kılıç
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey.
| | - Merve İşeri Nepesov
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey
| | - Hasan Bora Ulukapı
- Department of Pediatrics, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey
| | - Zeynep Canan Özdemir
- Division of Pediatric Hematology-Oncology, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey
| | - Özcan Bör
- Division of Pediatric Hematology-Oncology, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey
| | - Ener Çağrı Dinleyici
- Department of Pediatrics, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey
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12
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Oygar PD, Büyükçam A, Şahbudak Bal Z, Dalgıç N, Bozdemir ŞE, Karbuz A, Çetin BŞ, Kara Y, Çetin C, Hatipoğlu N, Uygun H, Aygün FD, Hançerli Törün S, Şener Okur D, Yılmaz Çiftdoğan D, Tural Kara T, Yahşi A, Özer A, Öcal Demir S, Akkoç G, Turan C, Salı E, Şen S, Erdeniz EH, Kara SS, Emiroğlu M, Erat T, Aktürk H, Laçinel Gürlevik S, Sütçü M, Gayretli Aydın ZG, Atikan BY, Yeşil E, Güner G, Çelebi E, Efe K, Kızmaz İşançlı D, Durmuş HS, Tekeli S, Karaarslan A, Bülbül L, Almış H, Kaba Ö, Ekemen Keleş Y, Yazıcıoğlu B, Bahtiyar Oğuz Ş, Ovalı HF, Doğan HH, Çelebi S, Çakır D, Karasulu B, Alkan G, Yenidoğan İ, Gül D, Parıltan Küçükalioğlu B, Avcu G, Kukul MG, Bilen M, Yaşar B, Üstün T, Kılıç Ö, Akın Y, Oral Cebeci S, Turgut M, Sarı Yanartaş M, Şahin A, Arslanoğlu S, Elevli M, Tüter Öz ŞK, Hatipoğlu H, Erkum İT, Demirbuğa A, Özçelik T, Ergül Sarı E, Akkuş G, Hatipoğlu SS, Dinleyici EÇ, Hacımustafaoğlu M, Özkınay F, Kurugöl Z, Cengiz AB, Somer A, Tezer H, Kara A. Education of Healthcare Personnel Working with Pediatric Patients During COVID-19 Pandemic within the Framework of Infection Control. J Pediatr Inf 2020. [DOI: 10.5578/ced.202061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
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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13
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Oygar PD, Büyükçam A, Şahbudak Bal Z, Dalgıç N, Bozdemir ŞE, Karbuz A, Çetin BŞ, Kara Y, Çetin C, Hatipoğlu N, Uygun H, Aygün FD, Hançerli Törün S, Şener Okur D, Yılmaz Çiftdoğan D, Tural Kara T, Yahşi A, Özer A, Öcal Demir S, Akkoç G, Turan C, Salı E, Şen S, Erdeniz EH, Kara SS, Emiroğlu M, Erat T, Aktürk H, Laçinel Gürlevik S, Sütçü M, Gayretli Aydın ZG, Atikan BY, Yeşil E, Güner G, Çelebi E, Efe K, Kızmaz İşançlı D, Durmuş HS, Tekeli S, Karaarslan A, Bülbül L, Almış H, Kaba Ö, Ekemen Keleş Y, Yazıcıoğlu B, Bahtiyar Oğuz Ş, Ovalı HF, Doğan HH, Çelebi S, Çakır D, Karasulu B, Alkan G, Yenidoğan İ, Gül D, Parıltan Küçükalioğlu B, Avcu G, Kukul MG, Bilen M, Yaşar B, Üstün T, Kılıç Ö, Akın Y, Oral Cebeci S, Bucak İH, Turgut M, Sarı Yanartaş M, Şahin A, Arslanoğlu S, Elevli M, Tüter Öz ŞK, Hatipoğlu H, Erkum İT, Demirbuğa A, Özçelik T, Ergül Sarı E, Akkuş G, Hatipoğlu SS, Dinleyici EÇ, Hacımustafaoğlu M, Özkınay F, Kurugöl Z, Cengiz AB, Somer A, Tezer H, Kara A. COVID-19 Pandemisinde Enfeksiyon Kontrol Çalışmaları Çerçevesinde Çocuk Hastalarla Çalışan Sağlık Personeli Eğitimi. J Pediatr Inf 2020. [DOI: 10.5578/ced.70235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
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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14
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Carman KB, Karal Y, Gülen Mert G, Ekici A, Perk P, Yarar C, Nuhoğlu Ç, Bozan G, Kılıç Ö, Dinleyici M, Şahin S, Atay E, Tokdemir U, Demir B, Dinleyici EÇ, Study Group DEE. The evaluation of vitamin K status in children with febrile seizure. Balkan Med J 2020; 38:116-120. [PMID: 33045823 PMCID: PMC8909255 DOI: 10.4274/balkanmedj.galenos.2020.2020.5.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Febrile seizure is the most common neurological disorder in childhood. The exact pathophysiology of febrile seizures is unknown. Recent studies showed the role of vitamin K in nonhematological and inflammatory disorders. This study aimed to investigate the serum vitamin K levels in children with febrile seizures. Aims To evaluate vitamin K levels in children with febrile seizures. Study Design Prospective case-control study. Methods This multicenter study examined representative populations in 8 different cities in Turkey between April 1, 2018 and April 1, 2019. Blood samples were taken from all children at presentation. Vitamin K1, vitamin K2, tumor necrosis factor-alpha, interleukin 1 beta, and interleukin 6 levels were determined by enzyme-linked immunosorbent assay. Results A total of 155 children were included in the study—84 children with febrile seizures and 71 children in febrile control group. Serum vitamin K1 and vitamin K2 levels were also higher in children with febrile seizures than in the controls. The results of statistical analysis showed that vitamin K1 and vitamin K2 levels were correlated with tumor necrosis factor-alpha, interleukin 1 beta, and interleukin 6 levels. The median vitamin K1 and vitamin K2 levels of children experiencing their first febrile seizure were higher than those in children with recurrent febrile seizures. Type of febrile seizure has no effect on serum vitamin K1 and vitamin K2 levels. Conclusion In children with febrile seizures, vitamin K levels are higher than those in the control group. These new findings may contribute to elucidating the etiopathogenesis of febrile seizures.
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Affiliation(s)
- Kürşat Bora Carman
- Department of Pediatric Neurology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Yasemin Karal
- Department of Pediatrics, Trakya University School of Medicine, Edirne, Turkey
| | - Gül Gülen Mert
- Department of Pediatric Neurology, Çukurova University School of Medicine, Adana, Turkey
| | - Arzu Ekici
- Clinic of Pediatric Neurology, Yüksek İhtisas Hospital, Bursa, Turkey
| | - Peren Perk
- Gaziantep Children's Hospital, Gaziantep, Turkey
| | - Coşkun Yarar
- Department of Pediatric Neurology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Çağatay Nuhoğlu
- Department of Pediatrics, Haydarpaşa Numune Eduction and Training Hospital, İstanbul, Turkey
| | - Gürkan Bozan
- Department of Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Ömer Kılıç
- Department of Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Meltem Dinleyici
- Department of Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Sabiha Şahin
- Department of Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Emrah Atay
- Department of Public Health, Eskişehir Osmangazi University School of Medicine, Eskisehir, Turkey
| | - Uğur Tokdemir
- Department of Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Baver Demir
- Gaziantep Children's Hospital, Gaziantep, Turkey
| | - Ener Çağrı Dinleyici
- Department of Pediatrics, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
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15
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İşeri Nepesov M, Dinleyici M, Kılıç Ö, Ceyhan M, Gürler N, Dinleyici EÇ. [Meningitis Due to Streptococcus pneumoniae Serotype 24B in a Patient with Cochlear Implant Previously Vaccinated with the Pneumococcal Vaccine]. MIKROBIYOL BUL 2019; 53:451-456. [PMID: 31709942 DOI: 10.5578/mb.68490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Streptococcus pneumoniae is a major cause of bacterial meningitis in children. It can progress and carries a serious risk of mortality and morbidity despite effective treatment. Cochlear implantation is a fairly successful procedure for restoring hearing in cases of sensorineural hearing loss. Moreover, patients with cochlear implants are at increased risk of contracting pneumococcal meningitis compared to the general population. The development of meningitis is associated with pathogens in the middle ear that contaminate the cerebrospinal fluid (CSF), as a result of congenital anomalies in the cochlea, and the cochlear implant. A 4-year-old girl presented to our clinic with fever, vomiting, and weakness. A physical examination showed an axillary temperature of 38.3°C, heart rate of 134/min, respiration rate of 50 breaths/minute, and arterial blood pressure of 120/88 mmHg. The patient also had a neck stiffness and her Kernig and Brudzinski signs were positive. It was discovered that the patient had undergone cochlear implantation approximately five months prior due to bilateral congenital sensorineural hearing loss. She had also received the Haemophilus influenzae type b and PCV-13 vaccines in line with the national immunization calendar. Her laboratory findings showed a leukocyte count of 21.900/mm3 (neutrophils 90% and lymphocytes 10%) and her procalcitonin level was 1.22 ng/ml. An uncountable number of neutrophils was identified in her cerebrospinal fluid, which led to the initial diagnosis of meningitis. There was also 1 mg/dl of glucose (blood glucose, 102 mg/dl) and 706 mg/dl of protein in her cerebrospinal fluid. Empirically, vancomycin (60 mg/kg/day) and ceftriaxone (100 mg/kg/day) were started. Following 5 days of antibiotic treatment, penicillin-susceptible S.pneumoniae was yielded in her CSF culture and identified as serotype 24B. S.pneumoniae with the same antibiotic sensitivity was also identified in her blood culture. Since rhinorrhea was observed on day 16 of hospitalization, she underwent an operation to repair the fistula tract. A computerized tomography cranial scan was performed after the development of acute mental fog at postoperative day 3 and showed brain edema and a thrombus in the right middle cerebral artery. The patient died on day 42 of hospitalization due to multiple organ failure. To our knowledge, this is the first case of meningitis reported in our country associated with S.pneumoniae serotype 24B in a patient with a cochlear implant. While there has been a decrease in the prevalence of invasive pneumococcal disease with routine administration of the pneumococcal conjugate vaccine, a relative increase has been observed in its non-vaccine serotypes. This is relevant not only to patients with more risk factors, such as a cochlear implant, but also those who are at lower risk for pneumococcal infection.
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Affiliation(s)
- Merve İşeri Nepesov
- Eskişehir Osmangazi University Faculty of Medicine, Division of Pediatric Infectious Diseases, Eskişehir, Turkey
| | - Meltem Dinleyici
- Eskişehir Osmangazi University Faculty of Medicine, Division of Social Pediatrics, Eskişehir, Turkey
| | - Ömer Kılıç
- Eskişehir Osmangazi University Faculty of Medicine, Division of Pediatric Infectious Diseases, Eskişehir, Turkey
| | - Mehmet Ceyhan
- Hacettepe University Faculty of Medicine, Division of Pediatric Infectious Diseases, Ankara, Turkey
| | - Nezahat Gürler
- Istanbul University Istanbul Faculty of Medicine, Department of Medical Microbiology, İstanbul, Turkey
| | - Ener Çağrı Dinleyici
- Eskişehir Osmangazi University Faculty of Medicine, Division of Pediatric Intensive Care Unit, Eskişehir, Turkey
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16
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Özdemir ZC, Bör Ö, Dinleyici EÇ, Kıral E. Re: Current treatment options for severe autoimmune hemolytic anemia. Turk Arch Pediatr 2018; 53:130-131. [PMID: 30116137 DOI: 10.5152/turkpediatriars.2018.2121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 09/06/2016] [Indexed: 11/22/2022]
Affiliation(s)
- Zeynep Canan Özdemir
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey.,Department of Pediatrics, Pediatric Intensive Care and Infectious Diseases Unit, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Özcan Bör
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey.,Department of Pediatrics, Pediatric Intensive Care and Infectious Diseases Unit, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Ener Çağrı Dinleyici
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey.,Department of Pediatrics, Pediatric Intensive Care and Infectious Diseases Unit, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Eylem Kıral
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey.,Department of Pediatrics, Pediatric Intensive Care and Infectious Diseases Unit, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
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Büyükcam A, Kara A, Bedir T, Gülhan B, Özdemir H, Sütçü M, Düzgöl M, Arslan A, Tekin T, Çelebi S, Kukul MG, Bayhan Gİ, Köşker M, Karbuz A, Çelik M, Kocabay Sütçü Z, Metin Ö, Karakaşlılar S, Dağlı A, Kara SS, Albayrak E, Kanık S, Tezer H, Parlakay A, Çiftci E, Somer A, Devrim İ, Kurugöl Z, Dinleyici EÇ, Atla P. Pediatricians' attitudes in management of acute otitis media and ear pain in Turkey. Int J Pediatr Otorhinolaryngol 2018; 107:14-20. [PMID: 29501295 DOI: 10.1016/j.ijporl.2018.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/15/2018] [Accepted: 01/17/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Acute otitis media (AOM) is predominantly a disease of childhood and one of the common reasons for prescribing antibiotics. Ear pain is the main symptom of AOM, with the result that parents frequently seek immediate medical assistance for their children. Antibiotic therapy for AOM does not provide symptomatic relief in the first 24 hours, and analgesics are commonly recommended for relieving the pain associated with AOM. The aims of the present study were to assess pediatricians' attitudes toward AOM and ear pain management in Turkey. METHODS This multicenter descriptive questionnaire study was conducted in 20 centers from different geographic locations in Turkey, with 977 pediatricians, between June 2015 and December 2016. The questionnaire comprised 20 questions focusing on the pediatricians' sociodemographic variables, experiences, and treatment related to AOM and ear pain. RESULTS Of the pediatricians, 58.2% were residents, 36.5% were specialists, and 4.3% were lecturers. Most participants were working in a university hospital (54.8%) or education and research hospital (32.2%). In general daily practice, the AOM diagnosis rates were between 6% and 20% in outpatient clinics, and 52.3% of the participants stated the patients complained about ear pain in pediatric clinics. The watchful waiting (WW) rate, as opposed to immediate antibiotic treatment, was 39.8% for all the pediatricians. The pediatric residents used the WW strategy less than the specialists and lecturers did (p = 0.004). The rates of the WW strategy were higher in outpatient clinics where AOM was commonly diagnosed (p < 0.001). The most common antibiotic prescribed for AOM was amoxicillin clavulanate (76.7%). The mean recommended treatment period for AOM was 9.3 ± 2.2 days. The choices for systemic ear pain treatment were acetaminophen (26.8%), ibuprofen (29.4%), and alternating between ibuprofen and acetaminophen (43.9%). Moreover, 34.6% of the participants recommended topical agents for otalgia. Topical agents were more commonly recommended by the pediatric residents than specialists or lecturers (p < 0.001). Finally, 58.3% of pediatricians had experiences of the parents' usage of a variety of herbal and folk remedies, such as breast milk or olive oil, for their children's ear pain. CONCLUSION Amoxicillin clavulanate was the most frequently prescribed antibiotic for AOM. WW was approved by the pediatricians, and having more AOM patients was a significant factor in the physicians' choice of WW; nevertheless, the WW rate was poor. Implementation of educational intervention strategies will help pediatricians in improving their compliance with evidence-based guidelines for AOM treatment. Otalgia is taken seriously by parents and pediatricians, and otalgia treatment seems to be well accepted in Turkey for providing symptomatic relief and enhancing the patients' quality of life.
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Affiliation(s)
- Ayşe Büyükcam
- Hacettepe University, Pediatric Infection Department, Ankara, Turkey.
| | - Ateş Kara
- Hacettepe University, Pediatric Infection Department, Ankara, Turkey
| | - Tuğba Bedir
- Gazi University, Pediatric Infection Department, Ankara, Turkey
| | - Belgin Gülhan
- Ankara Hematology Oncology Children's Training and Research Hospital, Pediatric Infection Department, Ankara, Turkey
| | - Halil Özdemir
- Ankara University, Pediatric Infection Department, Ankara, Turkey
| | - Murat Sütçü
- İstanbul University, Pediatric Infection Department, İstanbul, Turkey
| | - Mine Düzgöl
- Behçet Uz Training and Research Hospital, Pediatric Infection Department, İzmir, Turkey
| | - Aslı Arslan
- Ege University, Department of Pediatrics, İzmir, Turkey
| | - Tuna Tekin
- Eskişehir University, Department of Pediatrics, Eskişehir, Turkey
| | - Solmaz Çelebi
- Uludağ University, Pediatric Infection Department, Bursa, Turkey
| | - Musa Gürel Kukul
- Hacettepe University, Pediatric Infection Department, Ankara, Turkey
| | | | - Muhammet Köşker
- Diyarbakır Children Hospital, Pediatric Infection Department Diyarbakır, Turkey
| | - Adem Karbuz
- Okmeydanı Training and Research Hospital, Pediatric Infection Department, İstanbul, Turkey
| | - Melda Çelik
- Keçiöğren Training and Research Hospital, Pediatric Infection Department, Ankara, Turkey
| | - Zümrüt Kocabay Sütçü
- Süleymaniye Maternity and Children Hospital, Department of Pediatrics, İstanbul, Turkey
| | - Özge Metin
- Konya Training and Research Hospital, Pediatric Infection Department, Konya, Turkey
| | | | | | - Soner Sertan Kara
- Erzurum Training and Research Hospital, Pediatric Infection Department, Erzurum, Turkey
| | - Eda Albayrak
- Recep Tayip Erdoğan University, Department of Pediatrics, Rize, Turkey
| | - Saliha Kanık
- Ankara Hematology Oncology Children's Training and Research Hospital, Pediatric Infection Department, Ankara, Turkey
| | - Hasan Tezer
- Gazi University, Pediatric Infection Department, Ankara, Turkey
| | - Aslınur Parlakay
- Ankara Hematology Oncology Children's Training and Research Hospital, Pediatric Infection Department, Ankara, Turkey
| | - Ergin Çiftci
- Ankara University, Pediatric Infection Department, Ankara, Turkey
| | - Ayper Somer
- İstanbul University, Pediatric Infection Department, İstanbul, Turkey
| | - İlker Devrim
- Behçet Uz Training and Research Hospital, Pediatric Infection Department, İzmir, Turkey
| | - Zafer Kurugöl
- Ege University, Department of Pediatrics, İzmir, Turkey
| | | | - Pınar Atla
- Kırklareli State Hospital, Department of Pediatrics, Kırklareli, Turkey
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Özdemir ZC, Bör Ö, Dinleyici EÇ, Kıral E. Plasmapheresis in a child with cold antibody autoimmune hemolytic anemia: case report. Turk Arch Pediatr 2017; 52:169-172. [PMID: 29062252 DOI: 10.5152/turkpediatriars.2017.2956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 05/31/2016] [Indexed: 01/04/2023]
Abstract
Autoimmune hemolytic anemia is a picture of hemolysis which is caused by autoantibodies against red blood cell surface antigens. It is classified as primary, secondary or warm and cold autoimmune hemolytic anemia according to the temperature at which antibodies react. It is usually an acute and self-limiting condition. Here, we present a three-year-old male patient who presented with malaise, paleness, and dark-colored urine. His hemoglobin level was 5.8 g/dL, and increased indirect bilirubin and lactate dehydrogenase levels and decreased haptoglobulin and reticulocyte levels were noted. A direct Coombs test was positive using anti-C3. Four erythrocyte suspension transfusions were given because the anemia was life-threatening. High-dose steroids (30 mg/kg/ day, methylprednisolone) and intravenous immunoglobulin (1 g/kg/day, two days) treatments were unresponsive. Plasmapheresis was performed and no further transfusions were needed after plasmapheresis. Plasmapheresis treatment can be effective in children with cold type autoimmune hemolytic anemia.
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Affiliation(s)
- Zeynep Canan Özdemir
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Özcan Bör
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Ener Çağrı Dinleyici
- Department of Pediatrics, Division of Pediatric Intensive Care and Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Eylem Kıral
- Department of Pediatrics, Division of Pediatric Intensive Care and Infectious Diseases, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
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Ceyhan M, Dagan R, Sayiner A, Chernyshova L, Dinleyici EÇ, Hryniewicz W, Kulcsár A, Mad'arová L, Pazdiora P, Sidorenko S, Streinu-Cercel A, Tambić-Andrašević A, Yeraliyeva L. Surveillance of pneumococcal diseases in Central and Eastern Europe. Hum Vaccin Immunother 2016; 12:2124-2134. [PMID: 27096714 PMCID: PMC4994721 DOI: 10.1080/21645515.2016.1159363] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Pneumococcal infection is a major cause of morbidity and mortality worldwide. The burden of disease associated with S. pneumoniae is largely preventable through routine vaccination. Pneumococcal conjugate vaccines (e.g. PCV7, PCV13) provide protection from invasive pneumococcal disease as well as non-invasive infection (pneumonia, acute otitis media), and decrease vaccine-type nasopharyngeal colonisation, thus reducing transmission to unvaccinated individuals. PCVs have also been shown to reduce the incidence of antibiotic-resistant pneumococcal disease. Surveillance for pneumococcal disease is important to understand local epidemiology, serotype distribution and antibiotic resistance rates. Surveillance systems also help to inform policy development, including vaccine recommendations, and monitor the impact of pneumococcal vaccination. National pneumococcal surveillance systems exist in a number of countries in Central and Eastern Europe (such as Croatia, Czech Republic, Hungary, Poland, Romania and Slovakia), and some have introduced PCVs (Czech Republic, Hungary, Kazakhstan, Russia, Slovakia and Turkey). Those countries without established programs (such as Kazakhstan, Russia and Ukraine) may be able to learn from the experiences of those with national surveillance systems. The serotype distributions and impact of PCV13 on pediatric pneumococcal diseases are relatively similar in different parts of the world, suggesting that approaches to vaccination used elsewhere are also likely to be effective in Central and Eastern Europe. This article briefly reviews the epidemiology of pneumococcal disease, presents the latest surveillance data from Central and Eastern Europe, and discusses any similarities and differences in these data as well the potential implications for vaccination policies in the region.
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Affiliation(s)
- Mehmet Ceyhan
- a Department of Pediatric Infectious Diseases , School of Medicine, Hacettepe University , Ankara , Turkey
| | - Ron Dagan
- b Pediatric Infectious Disease Unit, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Abdullah Sayiner
- c Department of Chest Diseases , Ege University Faculty of Medicine , Izmir , Turkey
| | - Liudmyla Chernyshova
- d Department of Pediatric Infectious Diseases and Immunology , National Medical Academy for Postgraduate Education , Kiev , Ukraine
| | | | - Waleria Hryniewicz
- f National Medicines Institute, Division of Clinical Microbiology and Infection Prevention , Warsaw , Poland
| | - Andrea Kulcsár
- g Department of Infectology , Joint Hospital Saint László and Saint István , Budapest , Hungary
| | - Lucia Mad'arová
- h National Reference Centre for Pneumococcal and Haemophilus Diseases, Regional Authority of Public Health , Banská Bystrica , Slovak Republic
| | - Petr Pazdiora
- i Department of Epidemiology , Charles University Faculty Hospital , Pilsen , Czech Republic
| | - Sergey Sidorenko
- j Research Institute of Children's Infection , St. Petersburg , Russia
| | | | - Arjana Tambić-Andrašević
- l Department of Clinical Microbiology , University Hospital for Infectious Diseases , Zagreb , Croatia
| | - Lyazzat Yeraliyeva
- m Research Institute of Fundamental and Applied Medicine, Asfendiyarov Kazakh National Medical University , Almaty , Kazakhstan
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Temur E, Dinleyici EÇ, Tekin RT, Kiremitçi A, Sırmagül B, Yargıç ZA, Durmaz G, Tekin N, Bör Ö. Effects of Colistin Sulphate, Tigecycline, and Cefoperazone-Sulbactam on the Multi-Drug Resistant Acinetobacter baumannii Experimental Mouse Sepsis Model. J Pediatr Inf 2015. [DOI: 10.5152/ced.2015.1957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Öz Y, Dinleyici EÇ, İnan U, Kiraz N. Osteomyelitis Due to Aspergillus flavus in an Immunocompetent Child with Fatco Syndrome: A Case Report and Literature Review. J Pediatr Inf 2012. [DOI: 10.5152/ced.2012.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Kiremitçi A, Dinleyici EÇ, Yargıç ZA, Durmaz G, Tekin N, Aybey AD, Akşit MA. Prevalence and Risk Factors of Fecal Carriage of Extended-Spectrum β-lactamase (ESBL) -Producing Enterobacteriaceae in Hospitalized and Ambulatory Children. J Pediatr Inf 2011. [DOI: 10.5152/ced.2011.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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