Browsing by Author "Bal, ZS"
Now showing 1 - 8 of 8
Results Per Page
Sort Options
Item Is Monitoring of Cytomegalovirus Disease Required in Nontransplant Pediatric Acute Lymphoblastic Leukemia?Sen, S; Özdemir, HH; Karadas, N; Bal, ZS; Göktepe, SÖ; Ece, D; Balkan, C; Aydinok, Y; Karapinar, DYIntroduction: Cytomegalovirus (CMV) infections in developing countries are experienced at an early age. This study was performed to investigate the frequency of reactivation and risk factors of infection acquired at an early age of nontransplant acute lymphoblastic leukemia (ALL) patients receiving immunosuppressive therapy with weekly monitoring of CMV levels in Turkey. Materials and Methods: This was a retrospective, single-center study of 172 pediatric patients (102 boys and 70 girls) with ALL. All patients were monitored routinely for CMV-DNA at the initial presentation of leukemia and twice a week during chemotherapy. The CMV immunoglobulin (Ig)M/IgG titers were measured at admission. Results: CMV seropositivity at baseline was 90,11%. The overall prevalence of CMV infection (viremia) was 70.34%, 116 of whom were seropositive for CMV IgG and 5 of whom were negative for CMV at the time of ALL diagnosis. Reactivation was more common than de novo CMV infections (P=0.000). CMV seropositivity at the beginning of the leukemia diagnosis was found to be an independent predictor for developing CMV infection (P=0.001). A total of 60 CMV infection episodes were treated with antivirals. Four of these included organ involvement. The duration of CMV-DNA viremia episodes was longer in patients with CMV-DNA >= 1000 copies/mL (n=45) than in those with lower CMV-DNA levels (P=0.002). Infection was shown not to be associated with chemotherapy phase. Conclusion: This study suggests the importance of monitoring for CMV infections in developing countries because of frequent reactivations in seropositive ALL patients. It should be kept in mind that low CMV-DNA levels may also lead to organ involvement.Item The Evaluation of the Diagnostic Performance of the BioFire FilmArray Meningitis/Encephalitis Panel in Children: A Retrospective Multicenter StudyBal, A; Saz, EU; Arslan, SY; Atik, S; Bayturan, S; Yurtseven, A; Gazi, H; Cicek, C; Kurugol, Z; Bal, ZSObjective Acute bacterial meningitis (ABM) declined after implementing conjugate Haemophilus influenzae type B and the pneumococcal vaccines worldwide. However, it still contributes to significant morbidity and mortality. The Biofire FilmArray Meningitis Encephalitis (FAME) panel can rapidly diagnose common bacterial and viral pathogens. Several studies suggested that the use of FAME may accelerate diagnosis and decrease the time to pathogen-specific therapy. However, the clinical utility is still controversial due to scarce data and relatively high costs. Therefore, we aimed to evaluate the diagnostic performance of FAME in children. Methods A retrospective multicenter cross-sectional study was conducted to evaluate FAME in diagnosing ABM in children with a suspected central nervous system infection between January 2017 and May 2021. Results This study consisted of 179 children diagnosed with central nervous system infection who had parallel testing done using FAME and traditional microbiological diagnostic methods. Twenty-two FAME results were positive; 8 (36.3%) were bacterial pathogens and 14 (53.7%) were viral pathogens . The most common viral pathogen was human herpesvirus 6 (n =6; 27.2%), followed by herpes simplex virus 1 (n =4; 18.1%), Enterovirus spp. (n = 2; 9%), Parechovirus (n = 2; 9%), and Cytomegalovirus (n = 1; 4.5%). Bacterial pathogens included S. pneumoniae (n = 3; 13.6%), H. influenzae (n = 3; 13.6%), Neisseria meningitidis (n = 1; 4.5%), and Streptococcus agalactiae (n = 1; 4.5%). Bacterial culture confirmed S. pneumoniae infection in only 1 of 8 (12.5%) patients, while 7 of 8 bacterial meningitis were only detected by FAME. Conclusion FAME may also help with diagnosis and pathogen identification in patients who have already had antibiotics before cerebrospinal fluid collection. The use of FAME to detect infections quickly may minimize the improper use of medications, treatment duration, and the cost of hospitalization.Item Infections in children with left ventricular assist deviceSen, S; Ülger, Z; Bal, ZS; Özbaran, MBackground There are limited data about pediatric left ventricular assist device (VAD) infections in developing countries. This study aimed to investigate device postimplantation infectious complications and their pathogenic profile. Methods Data were analyzed from patient charts involving 27 patients with dilated cardiomyopathy who underwent left VAD implantation at a leading tertiary care center in Turkey. Results The study included 17 boys and ten girls with a median age of 12.22 years (range 17 months to 18 years). Nineteen patients were diagnosed with idiopathic, and three were diagnosed with familial dilated cardiomyopathy. Twenty-two out of 27 subjects (%81.48) developed 80 infection episodes in total. The most common type of left VAD-specific infection was the exit site of the driveline. Infected patients with left VAD had a significantly prolonged hospitalization compared with the patients without infection (P = .014). Infection-induced pediatric intensive care unit (ICU) admission was higher in patients with fungal infection(P = .023). Gram-positive staphylococci were the most commonly isolated bacterial pathogens, followed by Gram-negative bacteria. Five patients developed fungal infections. None of the fungal infection patients underwent transplantation(P = .035). Seven deaths occurred in our study group. All deaths were in the infected group. Mortality was associated with the presence of multidrug-resistant Gram-negative bacterial infections (P = .015), an increased number of infection episodes (P = .003), and hospitalization due to infection (P = .003). Conclusion Ventricular assist device-related infections were frequent among our study patients. The predominantly isolated agents were Gram-positive bacterial pathogens. However, the emergence of relatively high rate of Gram-negative bacterial and fungal infections was associated with mortality before the transplantation. Establishing local programs for surveillance data, controlling for infection rates, and antibiotic stewardship are essential to reduce mortality of VAD patients in developing countries.Item Adolescents With Breakthrough COVID-19 Infections Requiring Hospitalization: A Multicenter Retrospective StudyBal, ZS; Arslan, SY; Ozenen, GG; Okur, DS; Kiliçaslan,Ö; Demirbuga, A; Turgut, EA; Dalgic, N; Belet, N; Inceli, HB; Elvan-Tuz, A; Kara, TT; Bulbul, B; Demirdag, T; Çakici,Ö; Bal, A; Ergun, D; Altug, U; Arslan, A; Isancli, DK; Torun, SH; Çelik,Ü; Yasar, B; Erbas, IC; Oncel, EK; Akbas, A; Gudeloglu, E; Sen, S; Kacar, P; Dede, E; Petmezci, E; Aksoy, FD; Karbuz, A; Öncel, S; Tezer, H; Devrim, I; Ciftci, E; Hacimustafaoglu, M; Kurugol, ZBackground Vaccines have the most important role in the battle against the COVID-19 pandemic. With the widespread use of vaccines, COVID-19 has remarkably declined. Adolescents were vaccinated after approvals for this age group, which was later than adults, and a nationwide vaccination program was implemented in August 2021 in Turkey for adolescents >= 12 years of age. Therefore, we aimed to determine the effects of the COVID-19 nationwide adolescent vaccination program on adolescent hospitalizations due to COVID-19 and multisystem inflammatory syndrome in children (MIS-C) by comparing two periods, including the vaccination period (VP) and the pre-VP (PVP). The second aim of this study is to compare the clinical features and disease severity of vaccine-breakthrough COVID-19 hospitalizations with unvaccinated individuals in the VP. Methods A retrospective multicenter study was conducted to determine and compare the number of hospitalizations due to COVID-19 and MIS-C between the VP (September 1, 2021, to August 31, 2022) and PVP (September 1, 2020, to August 31, 2021). We also compared the characteristics, risk factors, and outcomes of breakthrough infections of adolescents aged 12-18, which required hospitalization with the same age group of unvaccinated hospitalized individuals during the VP. Results During the study period, 3967 children (0-18 years) were hospitalized in the PVP and 5143 (0-18 years) in the VP. Of them, 35.4% were adolescents (12-18 years) in the PVP, and this rate was 18.6% in the VP; relative risk was 0.6467 (95% confidence interval [CI]: 0.6058-0.6904; p < 0.001). Patients with breakthrough COVID- 19 were older (201 vs. 175 months, p < 0.001) and less commonly hospitalized for COVID-19 (81.5% vs. 60.4%, p < 0.001, odds ratio [OR]: 0.347 [95% CI: 0.184-0.654]). The majority of these infections were asymptomatic and mild (32% vs.72.9%: p < 0.001, OR: 5.718 [95% CI: 2.920-11.200]), and PICU admission was less frequently required (p = 0.011, OR: 0.188 [95% CI: 0.045-0.793]). Most breakthrough COVID-19 infections occurred within three months after the last vaccine dose (54.2%). Conclusions This study demonstrated a significant decrease in adolescent hospitalizations due to COVID-19 and MIS -C after implementing COVID-19 vaccines in Turkey. Breakthrough cases were less severe and mostly occurred three months after the last dose. This study emphasizes the importance of COVID-19 vaccines and that parents' decisions may be changed, particularly those who hesitate to or refuse vaccination.Item Evaluation of Attitudes and Knowledge of Influenza Diagnosis, Treatment and Vaccination Among Pediatric ResidentsGaripçin, P; Keles, YE; Öncel, EK; Kiymet, E; Böncüoglu, E; Özlü, CO; Asrak, HK; Özenen, GG; Ümit, Z; Kara, SS; Sen, S; Aksay, AK; Bal, ZS; Devrim, I; Belet, N; Çiftdogan, DYObjective: Influenza virus is common in children, especially in winter, causing hospitalization, admission to the intensive care unit, or even death. There are few studies on the attitudes or knowledge of influenza diagnosis, treatment, and vaccination among pediatricians. This study was planned to determine pediatric residents' attitudes and behaviors about recognizing the influenza virus, making treatment decisions, prophylaxis, and immunization. Material and Methods: This descriptive cross-sectional study was performed from 31 July-1 December 2019 among pediatric residents working in six different hospitals in the Aegean Region by an online survey. Twenty-seven questions were asked regarding articipant's demographic characteristics, recognition of the influenza symptoms, treatment, prophylaxis, and immunization. Results: Two hundred and four (58.5%) of 349 pediatric residents were included in the study, who answered the questionnaire. Among the participants, 72.5% were females, and their mean age was 27.9 +/- 2.1 years, and 59.3% worked as a pediatric residents for less than two years. When the symptoms of influenza were evaluated, the most known symptoms were fever (94.1%), myalgia (81.9%), tiredness (77.0%), headache (70.1%), and cough (68.6%). When oseltamivir treatment indications were questioned, most pediatric residents (82.2%) answered the questions. It was observed that 21.1% of the pediatric residents had the flu vaccine in the current season. According to the state of having chronic diseases, the rate of vaccination in participants was not statistically significant (p= 0.136). Conclusion: In this study, it was determined that pediatric residents' knowledge about influenza awareness, treatment, and immunization was insufficient. It may be beneficial to train pediatric residents about the influenza virus and vaccine before each influenza season.Item Education of Healthcare Personnel Working with Pediatric Patients During COVID-19 Pandemic within the Framework of Infection ControlOygar, PD; Büyükçam, A; Bal, ZS; Dalgiç, N; Bozdemir, SE; Karbuz, A; Çetin, BS; Kara, Y; Çetin, C; Hatipoglu, N; Uygun, H; Aygün, FD; Törün, SH; Okur, DS; Çiftdogan, DY; Kara, TT; Yahsi, A; Özer, A; Demir, SÖ; Akkoç, G; Turan, C; Sali, E; Sen, S; Erdeniz, EH; Kara, SS; Emiroglu, M; Erat, T; Aktürk, H; Gürlevik, SL; Sütçü, M; Aydin, ZGG; Atikan, BY; Yesil, E; Güner, G; Çelebi, E; Efe, K; Isançli, DK; Durmus, HS; Tekeli, S; Karaarslan, A; Bülbül, L; Almis, H; Kaba, Ö; Keles, YE; Yazicioglu, B; Oguz, SB; Ovali, HF; Dogan, HH; Çelebi, S; Çakir, D; Karasulu, B; Alkan, G; Yenidogan, I; Gül, D; Küçükalioglu, BP; Avcu, G; Kukul, MG; Bilen, M; Yasar, B; Üstün, T; Kiliç, Ö; Akin, Y; Cebeci, SO; Turgut, M; Yanartas, MS; Sahin, A; Arslanoglu, S; Elevli, M; Öz, SKT; Hatipoglu, H; Erkum, IT; Demirbuga, A; Özçelik, T; Sari, EE; Akkus, G; Hatipoglu, SS; Dinleyici, EÇ; Hacimustafaoglu, M; Özkinay, F; Kurugöl, Z; Cengiz, AB; Somer, A; Tezer, H; Kara, AObjective: 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.Item SARS-CoV-2 seropositivity among pediatric health care personnel after the first peak of the pandemic: nationwide surveillance in TurkeyOygar, PD; Büyükçam, A; Bal, ZS; Dalgiç, N; Bozdemir, SE; Karbuz, A; Çetin, BS; Kara, Y; Çetin, C; Hatipoglu, N; Uygun, H; Aygün, FD; Törün, SH; Okur, DS; Çiftdogan, DY; Kara, TT; Yahsi, A; Özer, A; Demir, SÖ; Akkoç, G; Turan, C; Sali, E; Sen, S; Erdeniz, EH; Kara, SS; Emiroglu, M; Erat, T; Aktürk, H; Gürlevik, SL; Sütçü, M; Aydin, ZGG; Atikan, BY; Yesil, E; Güner, G; Çelebi, E; Efe, K; Isançli, DK; Durmus, HS; Tekeli, S; Karaaslan, A; Bülbül, L; Almis, H; Kaba, Ö; Keles, YE; Yazicioglu, B; Oguz, SB; Ovali, HF; Dogan, HH; Çelebi, S; Çakir, D; Karasulu, B; Alkan, G; Yenidogan, I; Gül, D; Küçükalioglu, BP; Avcu, G; Kukul, MG; Bilen, M; Yasar, B; Üstün, T; Kiliç, Ö; Akin, Y; Cebeci, SO; Bucak, IH; Yanartas, MS; Sahin, A; Arslanoglu, S; Elevli, M; Çoban, R; Öz, SKT; Hatipoglu, H; Erkum, IT; Turgut, M; Demirbuga, A; Özçelik, T; Çiftçi, D; Sari, EE; Akkus, G; Hatipoglu, SS; Dinleyici, EÇ; Hacimustafaoglu, M; Özkinay, F; Kurugöl, Z; Cengiz, AB; Somer, A; Tezer, H; Kara, ABackground: 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.Item Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in TurkeyKarbuz, A; Akkoc, G; Demirdag, TB; Ciftdogan, DY; Ozer, A; Cakir, D; Torun, SH; Kepenekli, E; Erat, T; Dalgic, N; Ilbay, S; Karaaslan, A; Erdeniz, EH; Aygun, FD; Bozdemir, SE; Hatipoglu, N; Emiroglu, M; Bal, ZS; Ciftci, E; Bayhan, GI; Aydin, ZGG; Demir, SO; Kilic, O; Hacimustafaoglu, M; Okur, DS; Sen, S; Yahsi, A; Akturk, H; Cetin, B; Sutcu, M; Kara, M; Uygun, H; Kara, TT; Korukluoglu, G; Akgun, O; èstundag, G; Mis, MD; Sali, E; Kaba, O; Yakut, N; Kilic, O; Kanik, MK; Cetin, C; Dursun, A; Cicek, M; Kockuzu, E; Sevketoglu, E; Alkan, G; Ozenen, GG; Ince, E; Baydar, Z; Ozkaya, AK; Ovali, HF; Tekeli, S; Celebi, S; Cubukcu, B; Bal, A; Khalilova, F; Kose, M; Hatipoglu, HU; Dalkiran, T; Turgut, M; Altas, AB; Duru, HNS; Aksay, A; Saglam, S; Yanartas, MS; Ergenc, Z; Akin, Y; Kar, YD; Sahin, S; Tuteroz, SK; Bilen, NM; Ozdemir, H; Senoglu, MC; Kucukalioglu, BP; Besli, GE; Kara, Y; Turan, C; Demirtas, BS; Celikyurt, A; Cosgun, Y; Elevli, M; Sahin, A; Oguz, SB; Somer, A; Karadag, B; Demirhan, R; Dagi, HT; Kurugol, Z; Taskin, EC; Sahiner, A; Yesil, E; Keles, YE; Sarikaya, R; Eralp, EE; Ozkinay, F; Konca, HK; Yilmaz, S; Gokdemir, Y; Arga, G; Ozen, S; Coksuer, F; Vatansever, G; Tezer, H; Kara, AObjectives: The aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children. Methods: A retrospective study was conducted by pediatric infectious disease specialists from 32 different hospitals from all over Turkey by case record forms. Pediatric cases who were diagnosed as COVID-19 between March 16, 2020, and June 15, 2020 were included. Case characteristics including age, sex, dates of disease onset and diagnosis, family, and contact information were recorded. Clinical data, including the duration and severity of symptoms, were also collected. Laboratory parameters like biochemical tests and complete blood count, chest X-ray, and chest computed tomography (CT) were determined. Results: There were 1,156 confirmed pediatric COVID-19 cases. In total, male cases constituted 50.3% (n = 582) and females constituted 49.7% (n = 574). The median age of the confirmed cases was 10.75 years (4.5-14.6). Of the total cases, 90 were younger than 1 year of age (7.8%), 108 were 1-3 years of age (9.3%), 148 were 3-6 years of age (12.8%), 298 were 6-12 years of age (25.8%), 233 were 12-15 years of age (20.2%), and 268 cases were older than 15 years of age (23.2%). The most common symptom of the patients at the first visit was fever (50.4%) (n = 583) for a median of 2 days (IQR: 1-3 days). Fever was median at 38.4 degrees C (38.0-38.7 degrees C). The second most common symptom was cough (n = 543, 46.9%). The other common symptoms were sore throat (n = 143, 12.4%), myalgia (n = 141, 12.2%), dyspnea (n = 118, 10.2%), diarrhea (n = 112, 9.7%), stomachache (n = 71, 6.1%), and nasal discharge (n = 63, 5.4%). When patients were classified according to disease severity, 263 (22.7%) patients were asymptomatic, 668 (57.7%) patients had mild disease, 209 (18.1%) had moderate disease, and 16 (1.5%) cases had severe disease. One hundred and forty-nine (12.9%) cases had underlying diseases among the total cases; 56% of the patients who had severe disease had an underlying condition (p < 0.01). The need for hospitalization did not differ between patients who had an underlying condition and those who do not have (p = 0.38), but the need for intensive care was higher in patients who had an underlying condition (p < 0.01). Forty-seven (31.5%) of the cases having underlying conditions had asthma or lung disease (38 of them had asthma). Conclusions: To the best of our knowledge, this is one of the largest pediatric data about confirmed COVID-19 cases. Children from all ages appear to be susceptible to COVID-19, and there is a significant difference in symptomatology and laboratory findings by means of age distribution.