Browsing by Author "Kültürsay, N"

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    Molecular typing and sequencing of adenovirus isolated from a conjunctivitis outbreak in a neonatal intensive care unit by PCR
    Çiçek, C; Sanlidag, T; Bilgin, BS; Pullukçu, H; Akçali, S; Altun Köroglu, Ö; Yalaz, M; Kültürsay, N
    Aim: We aimed to evaluate the molecular typing of adenovirus isolated during an epidemic at the Ege University Children's Hospital neonatal intensive care unit (NICU). Materials and methods: During the NICU outbreak management, 40 clinical samples (from 15 newborn infants and 25 health care providers) were sent to a microbiology laboratory in viral transport media. All the samples were processed using a direct fluorescent antibody (DFA) test and a shell vial cell culture followed by adenovirus polymerase chain reaction (PCR) and DNA sequencing. PCR and DNA sequencing for adenovirus hexon gene hypervariable regions 1-6 were done after DNA extraction from clinical specimens. Adenovirus typing was done using BLAST analysis. Results: Ten adenoviruses were isolated from 4 out of 10 infants, 3 out of 5 hospital staff with conjunctivitis, and 3 asymptomatic staff. Ten positive samples were identified as adenovirus type 8 by using BLAST analysis. Conclusion: We isolated adenovirus type 8, one of the most common serotypes causing conjunctivitis, during an adenovirus outbreak in our NICU. The highest positivity was obtained using the PCR method. Although DFA was positive in a limited number of cases, this test was applied rapidly at the beginning of the epidemic and contributed to the prevention of further spread.
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    Early Immunomodulatory Effects of Different Natural Surfactant Preparations in Preterms With Respiratory Distress
    Yalaz, M; Tanriverdi, S; Uygur, Ö; Köroglu, ÖA; Azarsiz, E; Aksu, G; Kültürsay, N
    BackgroundRespiratory distress syndrome (RDS) is the most common respiratory disease in premature infants. Exogenous natural surfactant preparations are used in the treatment of RDS. In recent years, it has become increasingly evident that surfactant plays an immunoregulatory role. ObjectivesThe aim of this study was to evaluate cytokine and chemokine response following three different regimens of natural surfactant treatment in preterm newborns with RDS. MethodsPremature newborns below 32 weeks of gestation who were intubated for RDS and given early surfactant rescue therapy were included in the study. Newborns were randomly divided into three groups and Beractant 100 mg/kg (B-100), Poractant alfa 100 mg/kg (P alpha-100) and Poractant alfa 200 mg/kg (P alpha-200) were administered intratracheally. Blood samples and transtracheal aspirates (TA) were collected just before and 4-6 h after the surfactant treatment. Total eosinophil count, inducible T Cell alpha chemoattractant (ITaC), macrophage inflammatory protein 3 beta (MIP3b), interleukins (IL) 5, 8, 9, 10, 13, immunoglobulin E (IgE), interferon gamma (IFN-gamma), eotaxin and tumor necrosis factor beta-1 (TGF-beta 1) were measured from blood and tracheal aspirate samples. ResultsA total of 45 infants, 15 in each group, were included in the study. Mean gestational age, birth weight, antenatal, demographic and clinical characteristics of the study groups were similar. IFN gamma concentration and eosinophil counts in TA decreased after surfactant replacement in all groups, especially in the infants treated with P alpha-100 and P alpha-200. Eotaxin, TGF beta and IL-8 concentrations in TA increased significantly in the infants treated with P alpha-100 and P alpha-200. IL-9 levels in TA decreased in the B-100 group but increased in the P alpha-100 and P alpha-200 groups. Blood levels of cytokines and chemokines showed significantly decreased levels of ITaC and MIP3b only in the B-100 group, but no significant change was observed in the P alpha-100 and P alpha-200 groups. ConclusionIn our study, the different immunomodulatory effects of natural surfactant preparations on newborn lung is proven. We found that Poractant alpha, one of the natural surfactant preparations, shifted the lung immune system toward TH2.
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    Nosocomial infections in neonatal units in Turkey: epidemiology, problems, unit policies and opinions of healthcare workers
    Oygür, N; Kavuncuoglu, S; Özbek, S; Tansug, N; Perk, Y; Ilikkan, B; Satar, M; Yildiztas, HY; Duman, N; Kumral, A; Zenciroglu, A; Tanir, G; Kültürsay, N; Köröglu, ÖA; Aksit, A; Tekin, N; Yigit, S; Korkmaz, A; Gökalp, AS; Arisoy, AE; Özek, E; Bilgen, H; Atici, A; Turhan, AH; Çetin, H; Acunas, B; Vatansever, Ü; Say, A; Güven, F
    Turkish Neonatal Society Nosocomial Infections Study Group. Nosocomial infections in neonatal units in Turkey: epidemiology, problems, unit policies and opinions of healthcare workers. Turk J Pediatr 2010; 52: 50-57. The epidemiology of nosocomial infections in Turkish neonatal intensive care units (NICUs) shows that nosocomial sepsis is an important problem, especially for very low birth weight (VLBW) infants, and gram-negative agents, particularly Klebsiella species, are still the major causes of nosocomial infections. Sepsis frequency was 6.4%, ranging from 2.1 to 17%, in 16 centers in Turkey. Sepsis frequency was 22% in infants <1500 g, 6% in those 1500-2500 g, and 3% in those >2500 g. Sepsis-related mortality was 24.4 for 100 sepsis cases, ranging from 0 to 75 for 100 cases. Ventilator-associated pneumonia frequency was 1.7%, catheter-related infection frequency was 0.14% and urinary tract infection frequency was 3.7%. Healthcare workers (HCWs) complain of the inadequacy of some basic facilities and of staffing; however, they are aware of the causes and solutions and are willing to overcome this major health problem. We conclude that Turkish neonatal HCWs are quite optimistic about preventing neonatal nosocomial infections.