Browsing by Author "Yilmaz, AT"

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    Evaluation of 601 children with multisystem inflammatory syndrome (Turk MISC study)
    Yilmaz, D; Keles, YE; Emiroglu, M; Duramaz, BB; Ugur, C; Kocabas, BA; Celik, T; Ozdemir, H; Bayturan, S; Turel, O; Erdeniz, EH; Cakici, O; Taskin, EC; Erbas, IC; Genceli, M; Sari, EE; Caymaz, C; Kizil, MC; Sutcu, M; Demirbuga, A; Alkan, G; Bagci, Z; Dayar, GT; Ozkan, EA; Yilmaz, AT; Akca, M; Yesil, E; Kara, SS; Akturk, H; Yasar, B; Umit, Z; Uygun, H; Erdem, N; Buyukcam, A; Oncel, EK; Oz, SKT; Cetin, HS; Anil, AB; Yilmaz, R; Zengin, N; Uzuner, S; Albayrak, H; Borakay, O; Topal, S; Arslan, G; Yazar, A; Ozer, A; Kendirli, T; Kara, EM; Demirkol, D; Battal, F; Kosker, M; Akcan, OM; Kihtir, HS; Gul, D; Zararci, K; Alakaya, M; Kula, N; Celik, E; Petmezci, E; Evren, G; Aksay, AK; Konca, C; Sert, A; Arslan, D; Bornaun, H; Tekeli, O; Bal, A; Sahin, IO; Demir, S; Sap, F; Akyol, MB; Tanidir, IC; Donmez, YN; Ucar, T; Coban, S; Arga, G; Torun, SH; Karpuz, D; Celik, SF; Varan, C; Elmali, F; Oncel, S; Belet, N; Hatipoglu, N; Karabulut, ND; Turgut, M; Somer, A; Kuyucu, N; Dinleyici, EC; Ciftci, E; Kara, A
    Purpose Due to its link with the 2019 coronavirus, the multisystem inflammatory syndrome in children (MISC) has garnered considerable international interest. The aim of this study, in which MISC patients were evaluated multicenter, and the data of the third period of the Turk-MISC study group, to compare the clinical and laboratory characteristics and outcomes of MISC patients who did and did not require admission to an intensive care unit (ICU).Methods This retrospective multicenter observational study was carried out between June 11, 2021, and January 01, 2022. The demographics, complaints, laboratory results, system involvements, and outcomes of the patients were documented.Results A total of 601 patients were enrolled; 157 patients (26.1%) required hospitalization in the intensive care unit (ICU). Median age was 8 years (interquartile range (IQR) 4.5-11.3 years. The proportion of Kawasaki disease-like features in the ICU group was significantly higher than in the non-ICU group (56.1% vs. 43.2% p = 0.006). The ICU group had considerably lower counts of both lymphocytes and platelets (lymphocyte count 900 vs. 1280 cells x mu L, platelet count 153 vs. 212 cells x 10(3)/ mu L, all for p< 0.001). C-reactive protein, procalcitonin, and ferritin levels were significantly higher in the ICU group (CRP 164 vs. 129 mg/L, procalcitonin 9.2 vs. 2.2 mu g/L, ferritin 644 vs. 334 mu g/L, all for p< 0.001). Being between ages 5-12 and older than 12 increased the likelihood of hospitalization in the ICU by four [95% confidence intervals (CI)1.971-8.627] and six times (95% CI 2.575-14.654), respectively, compared to being between the ages 0-5. A one-unit increase in log d-dimer (mu g/L) and log troponin (ng/L) was also demonstrated to increase the need for intensive care by 1.8 (95% CI 1.079-3.233) and 1.4 times (95% CI 1.133-1.789), respectively. Conclusion: By comparing this study to our other studies, we found that the median age of MISC patients has been rising. Patients requiring an ICU stay had considerably higher levels of procalcitonin, CRP, and ferritin but significantly lower levels of lymphocyte and thrombocyte. In particular, high levels of procalcitonin in the serum might serve as a valuable laboratory marker for anticipating the need for intensive care.
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    Antibiotic associated diarrhea in outpatient pediatric antibiotic therapy
    Basaranoglu, ST; Karaaslan, A; Sali, E; Çiftçi, E; Aydin, ZGG; Kocabas, BA; Kaya, C; Bayturan, SS; Kara, SS; Çiftdogan, DY; Çay, Ü; Aktürk, HG; Çelik, M; Ozdemir, H; Somer, A; Diri, T; Yazar, AS; Sütçü, M; Tezer, H; Oncel, EK; Kara, M; Çelebi, S; Parlakay, AÖ; Karakaslilar, S; Arisoy, ES; Tanir, G; Kara, TT; Devrim, I; Erat, T; Aykaç, K; Kaba, Ö; Güven, S; Yesil, E; Yilmaz, AT; Durmus, SY; Çaglar, I; Günay, F; Özen, M; Dinleyici, EÇ; Kara, A
    BackgroundAntibiotic-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.MethodsThe 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.ResultsA 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.ConclusionThis study on pediatric antibiotic-associated diarrhea displayed epidemiological data and the differences geographically in our region.
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    A snapshot of pediatric inpatients and outpatients with COVID-19: a point prevalence study from Turkey
    Yilmaz, D; Üstündag, G; Büyükçam, A; Sali, E; Çelik, Ü; Avcu, G; Belet, N; Taskin, EÇ; Demir, SÖ; Birbilen, AZ; Kiliç, Ö; Akcan, ÖM; Yilmaz, AT; Kocabas, BA; Hatipoglu, N; Karbuz, A; Çakir, D; Sütçü, M; Aygün, FD; Çelik, T; Sen, SB; Dalgiç, N; Ümit, Z; Kara, SS; Öncel, EK; Bolat, A; Çil, MK; Turan, C; Guzin, AÇ; Topal, S; Besli, GE; Dogan, G; Sahin, S; Akin, F; Bildirici, Y; Dayar, GT; Sari, EE; Isançli, DK; Kara, M; Önal, P; Aylaç, H; Lüleci, D; Yasar, B; Dede, E; Çaglar, A; Akova, S; Turgut, EA; Özkaya, PY; Gülmez, TK; Ulusoy, E; Duyu, M; Kara, Y; Çeliktas, H; Tekeli, O; Çaglar, F; Gül, D; Cebeci, SO; Battal, F; Bal, A; Aygün, E; Uysalol, M; Arslan, G; Özkavakli, A; Kizil, MC; Yazar, A; Aygün, F; Somer, A; Kuyucu, N; Dinleyici, EÇ; Kara, A
    This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID19). 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.
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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.