Browsing by Author "Kurugol, Z"

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    The Evaluation of the Diagnostic Performance of the BioFire FilmArray Meningitis/Encephalitis Panel in Children: A Retrospective Multicenter Study
    Bal, A; Saz, EU; Arslan, SY; Atik, S; Bayturan, S; Yurtseven, A; Gazi, H; Cicek, C; Kurugol, Z; Bal, ZS
    Objective 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.
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    Ratios of Nine Risk Factors in Children With Recurrent Febrile Seizures
    Tosun, A; Koturoglu, G; Serdaroglu, G; Polat, M; Kurugol, Z; Gokben, S; Tekgul, H
    Febrile seizures are the most common convulsive disorder of childhood, with a recurrence probability of 33%. The aim of the study was to determine the risk factors for recurrence of febrile seizures in children. In this descriptive, cross-sectional study, nine risk factors of recurrence of febrile seizures were investigated in 259 children with febrile seizures: (1) sex; (2) domicile; (3) income level; (4) family history of febrile seizures; (5) family history of epilepsy; (6) level of fever; (7) duration of fever; (8) type of seizure, simple vs complex; and (9) age at seizure onset. The risk factors were compared for 119 children with isolated febrile seizures (45.9% of the total) and 140 children with two or more febrile seizure recurrences (54.1%). Among the patients with and without recurrent febrile seizures, 32% and 18% were domiciled in nonurban areas, respectively (P = 0.012). There was a family history of febrile seizures in 57% and 44% of cases with and without recurrent febrile seizures, respectively (P = 0.031). According to the logistic regression analysis, a family history of febrile seizures was a risk factor that affected recurrence (P = 0.018; odds ratio OR = 1.933; 95% confidence interval CI = 1.121-3.333). We also found that domicile (P = 0.001) and income (P = 0.013) were risk factors for recurrence. A family history of epilepsy was not a significant risk factor (P = 0.129; OR = 2.110; 95% CI = 0.804-5.539). (C) 2010 by Elsevier Inc. All rights reserved.
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    Adolescents With Breakthrough COVID-19 Infections Requiring Hospitalization: A Multicenter Retrospective Study
    Bal, 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, Z
    Background 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.
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    Antifungal consumption, indications and selection of antifungal drugs in paediatric tertiary hospitals in Turkey: Results from the first national point prevalence survey
    Çaglar, I; Devrim, I; Özdemir, H; Sahbudak, Z; Sönmez, G; Buyukcam, A; Gulhan, B; Kara, A; Aygun, DF; Bayram, N; Celebi, S; Çetin, B; Nepesov, MI; Yilmaz, AT; Kepenekli, E; Çiftdogan, DY; Acar, MK; Yayla, BC; Okumus, C; Ecevit, Z; Hatipoglu, N; Kuyucu, N; Kosker, M; Sen, S; Karbuz, A; Sutcu, M; Duramaz, BB; Özen, M; Çiftçi, E; Alabaz, D; Kurugol, Z; Kara, A; Kanik, S; Kilic, O; Oncel, S; Somer, A; Tapisiz, A; Belet, N; Akcan, ÖM; Türel, Ö; Ozkaya, A; Tezer, H; Cengiz, AB; Ince, E; Camcioglu, Y; Kocabas, E; Arisoy, ES; Salman, N
    Objectives: The aim of this point prevalence survey was to evaluate the consumption, indications and strategies of antifungal therapy in the paediatric population in Turkey. Methods: A point prevalence study was performed at 25 hospitals. In addition to general data on paediatric units of the institutes, the generic name and indication of antifungal drugs, the presence of fungal isolation and susceptibility patterns, and the presence of galactomannan test and high-resolution computed tomography (HRCT) results were reviewed. Results: A total of 3338 hospitalised patients were evaluated. The number of antifungal drugs prescribed was 314 in 301 patients (9.0%). Antifungal drugs were mostly prescribed in paediatric haematology and oncology (PHO) units (35.2%), followed by neonatal ICUs (NICUs) (19.6%), paediatric services (18.3%), paediatric ICUs (PICUs) (14.6%) and haematopoietic stem cell transplantation (HSCT) units (7.3%). Antifungals were used for prophylaxis in 147 patients (48.8%) and for treatment in 154 patients (50.0%). The antifungal treatment strategy in 154 patients was empirical in 77 (50.0%), diagnostic-driven in 29 (18.8%) and targeted in 48 (31.2%). At the point of decision-making for diagnostic-driven antifungal therapy in 29 patients, HRCT had not been performed in 1 patient (3.4%) and galactomannan test results were not available in 12 patients (41.4%). Thirteen patients (8.4%) were receiving eight different antifungal combination therapies. Conclusion: The majority of antifungal drugs for treatment and prophylaxis were prescribed in PHO and HSCT units (42.5%), followed by ICUs. Thus, antifungal stewardship programmes should mainly focus on these patients within the availability of diagnostic tests of each hospital. (C) 2018 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.
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    Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey
    Karbuz, 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, A
    Objectives: 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.