Browsing by Author "ÇELEBİ, SOLMAZ"
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Publication A comparison of chlorhexidine and povidone-iodine solutions in neonatal intensive care units(Wiley, 2023-01) Küçüker, Hakan; Çakır, Salih Çağrı; Köksal, Nirgül; Özkan, Hilal; Kocael, Fatma; Dorum, Bayram Ali; Yıldırım, Cansu Sivrikaya; Çelebi, Solmaz; Hacımustafaoğlu, Mustafa; KÜÇÜKER, HAKAN; ÇAKIR, SALİH ÇAĞRI; KÖKSAL, FATMA NİRGÜL; ÖZKAN, HİLAL; KOCAEL, FATMA; SİVRİKAYA YILDIRIM, CANSU; ÇELEBİ, SOLMAZ; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Dorum, Bayram Ali; Bursa Uludağ Üniversitesi/Tıp Fakültesi; 0000-0002-1636-5819; 0000-0001-5761-4757; 0000-0002-1787-6872; 0000-0003-4646-660X; 0000-0002-2823-8454; CZJ-5958-2022; HJZ-4508-2023; CZV-1969-2022; IGT-7005-2023; DXK-0792-2022; A-5375-2017; KGF-7434-2024; ENK-4130-2022; CTG-5805-2022Background: Povidone-iodine (10%; PI) and 2% chlorhexidine in 70% isopropyl alcohol (CHG-IA) solutions are among the most widely used disinfectants in the neonatal intensive care units. This study compares the use of these disinfectants and helps decide which is superior to the other for neonatal use.Methods: All term and preterm infants born and hospitalized in Bursa Uludag University Hospital between July 2018-March 2020 were included. The infants were randomized into two disinfectant groups before birth. The application site was cleaned with the assigned disinfectant before intervention. The infants were screened for rates of neonatal sepsis, thyroid-stimulating hormone (TSH) levels, free thyroxine (fT4) levels, skin reactions to the assigned solution, and acute neurological side effects.Results: We enrolled 208 term and preterm infants (PI:104 vs. CHG-IA: 104) in the study. The prematurity rates were identical (PI: 74.0%; CHG-IA: 72.1%; p = 0.755). Neonatal sepsis rates among these groups were not statistically different (PI: 8.7%; CHG-IA: 4.8%; p = 0.406). The median TSH value of the PI group was high (4.05 mIU/L) in comparison with that of the CHG-IA group (3.09 mIU/L; p = 0.016). No cutaneous or neurological side effects were recorded in patients treated with CHG-IA solution.Conclusions: Although these two solutions were equally protective against infections, the CHG-IA solution was a better alternative to PI for neonatal use. Considering that the PI solution may be responsible for impaired thyroid function, the CHG-IA solution is a good alternative because it provides sufficient protection with a safer adverse effect profile.Publication A patient with breast mass and hyperemia(Aves Yayıncılık, 2007-06-01) Aktürk, Berna; Çelebi, Solmaz; Aktürk, Berna; ÇELEBİ, SOLMAZ; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlıkları ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Hastalıkları Bilim; CAS-1783-2022; JOA-9028-2023Publication Comparative evaluation of health care-related infections in pediatric and newborn intensive care units in a university hospital: The seven-year retrospective study(Galenos Yayınevi, 2021-08-01) Özaslan, Zeynep; Çelebi, Solmaz; Köksal, Nilgün; Özkan, Hilal; Ocakoğlu, Gökhan; Yeşil, Edanur; Özer, Arife; Turan, Cansu; Bülbül, Beyhan; Hacımustafaoğlu, Mustafa Kemal; ÖZASLAN, NEBAHAT ZEYNEP; ÇELEBİ, SOLMAZ; Köksal, Nilgün; ÖZKAN, HİLAL; OCAKOĞLU, GÖKHAN; YEŞİL, EDANUR; Özer, Arife; TURAN, CANSU; BÜLBÜL, BEYHAN; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Neonotoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0001-9400-7825; 0000-0002-1114-6051; 0000-0002-8926-9959; 0000-0003-3146-6391; 0000-0002-5720-1212; 0000-0003-4646-660X; 0000-0003-2641-4140; 0000-0002-3536-0263; 0000-0001-5454-5119; 0000-0001-9232-0084; GSO-3630-2022; JCD-9679-2023; A-1302-2018; AAH-5180-2021; JHN-1091-2023; JGS-7600-2023; JJY-3921-2023; IVB-4013-2023; GAX-3172-2022; CTG-5805-2022; JHR-3083-2023Introduction: In this study, it was aimed to evaluate the incidence, density and reciprocal relationships of Health Care Associated Infections (HCAIs) detected in the Pediatric Intensive Care Unit (PICU) and Neonatal Intensive Care Unit (NICU) in Bursa Uludag University Faculty of Medicine Hospital as a general perspective.Materials and Methods: In this study, data of 91 PICU and 158 NICU patients who developed HCAIs between 2012-2018 years, taking into account the criteria of the Centers for Disease Control and Prevention (CDC) 2015 and the Turkish National Hospital Infections Surveillance Network (UHESA) 2017, were retrospectively analyzed.Results: The HCAIs rate was higher in NICU (9.6% vs 14.9%; respectively, p <0.001), but the infection density was lower (9.9 versus 7.8/1000 patient days, p=0.061). Stay of length for all patients in NICU was found to be longer (19.1 days vs 9.7 days; p <0.001), and the median length of stay with HCAIs in PICU and in NICU was 41.5 days versus 49 days respectively (p=0.1). The median time of HCAIs diagnosis was 17 days in PICU vs 15 days in NICU, p=0.6). In NICU, according to birth weight, HCAIs rates and infection densities were 7.8% and 2.7/1000 patient-days in <750 g patients; 23.2% and 6.2/1000 patient-days in 751-1000 g patients, 6.1% and 4.9 patient-days in 1001-1500 g patients, 44.7% and 9.2/1000 patient-days in 1501-2500 g patients, and %24.6 and 13.8/1000 patient-days in >2501 g patients. HCAIs rates were found to be higher in babies with >1501 g.Conclusions: There may be differences in the rates and prevention strategies in PICU and NICU and continuous and high quality maintenance is important for infection control measures.Publication Diagnostic value of mediastinal lymphadenopathy in differentiating pulmonary tuberculosis from community-acquired pneumonia in children(Briefland, 2022-08-01) Uçar, Ayşe Kalyoncu; Yeşil, Edanur; YAZICI, ZEYNEP; Yazıcı, Zeynep; ÇELEBİ, SOLMAZ; Hacımustafaoğlu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Ocakoğlu, Gökhan; OCAKOĞLU, GÖKHAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Bioistatistik Anabilim Dalı.; 0000-0003-4646-660X; 0000-0002-1114-6051; AAH-5180-2021Background: Diagnosis of childhood pulmonary tuberculosis (TB) is often based on clinical features in combination with radiologic findings because of paucibacillary nature of the disease in children. It may be difficult to make a clinical diagnosis because of the overlapping clinical features of pulmonary TB and community-acquired pneumonia (CAP). On computed tomography (CT) scanning, the presence of typical LAP can suggest TB as a possible cause. Objectives: To compare the features of mediastinal LAPs between two patient groups based on contrast-enhanced chest CT. Methods: A total of 45 pulmonary patients with TB and 38 patients with CAP (aged <= 18 years) were enrolled in this retrospective study. The presence and CT features of lymph node involvement and the incidence of associating parenchymal/pleural findings were analyzed in two groups. Results: All patients with TB and 36 of the 38 patients with CAP had at least one mediastinal LAP. There was no significant difference between the two groups according to the incidence of lymph node and multiple site involvement and also involved lymph node stations (P > 0.05). However, lymph node size was larger in the TB group (P = 0.04). Twenty-two percent of patients with TB had mediastinal LAP without parenchymal/pleural involvement. Conclusions: Although the lymph node size was larger in TB group than in CAP group, CT features of mediastinal lymph node involvement overlapped between two groups. Nevertheless, mediastinal LAP without parenchymal/pleural involvement on CT is seen in a significant number of TB patients.Publication Education of healthcare personnel working with pediatric patients during covid-19 pandemic within the framework of infection control(Aves Yayıncılık, 2020-11-28) Oygar, Pembe Derin; Büyükcam, Ayşe; Bal, Zümrüt Şahbudak; Dalgıc, Nazan; Bozdemir, Sefika Elmas; Karbuz, Adem; Çetin, Benhur Şırvan; Kara, Yalçın; Çetin, Ceren; Hatipoğlu, Nevin; Uygun, Hatice; Aygün, Fatma Deniz; Torun, Selda Hançerli; Okur, Dicle Şener; Çiftdoğan, Dilek Yılmaz; Kara, Tuğçe Tural; Yahşi, Aysun; Özer, Arife; Demir, Sevliya Ocal; Akkoç, Gülsen; Turan, Cansu; Salı, Enes; Şen, Semra; Erdeniz, Emine Hafize; Kara, Soner Sertan; Emiroğlu, Melike; Erat, Tuğba; Aktürk, Hacer; Gürlevik, Sibel Laçinel; Sütcü, Murat; Aydın, Zeynep Gökçe Gayretli; Atıkan, Başak Yıldız; Yeşil, Edanur; Güner, Gizem; Çelebi, Emel; Efe, Kadir; İsançlı, Didem Kızmaz; Durmuş, Habibe Selver; Tekeli, Seher; Karaarslan, Ayşe; Bülbül, Lida; Almış, Habip; Kaba, Özge; Keles, Yıldız Ekemen; Yazıcıoğlu, Bahadir; Oğuz, Şerife Bahtiyar; Ovalı, Hüsnü Fahri; Doğan, Hazal Helin; Çelebi, Solmaz; Çakır, Deniz; Karasulu, Burcugül; Alkan, Gülsüm; Yenidoğan, İrem; Gül, Doruk; Küçükalioğlu, Burcu Parıltan; Avcu, Gülhadiye; Kukul, Musa Gürel; Bilen, Melis; Yaşar, Belma; Üstün, Tuğba; Kılıç, Ömer; Akın, Yasemin; Cebeci, Sinem Oral; Turgut, Mehmet; Yanartaş, Mehpare Sarı; Şahin, Aslıhan; Arslanoğlu, Sertaç; Elevli, Murat; Öz, Sadiye Kübra Tuter; Hatipoğlu, Halil; Erkum, İlyas Tolga; Demirbuğa, Asuman; Özçelik, Taha; Sarı, Emine Ergül; Akkuş, Gökhan; Hatipoğlu, Sadık Sami; Dinleyici, Ener Cağrı; Hacımustafaoğlu, Mustafa; Özkinay, Ferda; Kuruğol, Zafer; Cengiz, Ali Bülent; Somer, Ayper; Tezer, Hasan; Kara, Ateş; ÇELEBİ, SOLMAZ; TURAN, CANSU; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Hastalıkları Bilim Dalı.; IVB-4013-2023; JHN-1091-2023; CTG-5805-2022Objective: 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.Publication Evaluation of children cases admitted for tick bite in uludag university medicine of faculty(Aves Yayincilik, Ibrahim Kara, 2010-12-01) ÇELEBİ, SOLMAZ; Çelebi, Solmaz; KILIÇ, UĞUR; Aydın, Levent; AYDIN, LEVENT; Hacımustafaoğlu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Çelik, Uğur; Çakır, Deniz; Emir, Begüm Runa; Çetin, Meryem; Bursa Uludağ Üniversitesi/Veteriner Fakültesi/Parazitoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları Anabilim Dalı.; 0000-0003-4646-660X; 0000-0002-7056-0615; GQP-2135-2022Objective: Crimean-Congo hemorrhagic fever (CCHF) virus causes a severe disease in humans, with a mortality of up to 30%. The geographical environment of our country is suitable for ticks. The aim of this study was to evaluate the clinical, and laboratory characteristics of children admitted for tick bites and determine the species of tick removed from the children.Material and Methods: Between April 2009 and September 2009, a total of 104 cases who had tick bites were included in the study. Detailed demographic, laboratory and clinical data were prospectively collected for each patient using a standardized questionnaire.Results: During the study period, a total of 104 children were admitted for tick bite. The mean age of patients was 7.3 +/- 4.4 years (1-18 years) and 71% were female. Most of the children (58%) were living in the rural region of Bursa. Of the 104 reported tick bites, most were nymphs of Rhipicephalus spp (42.3%) and larvae of Rhipicephalus spp (22.1%). Larvae of Ixodes spp (8.6%), nymphs of Ixodes spp. (6.7%), nymphs of Hyalomma spp. (4.8%) and adults of H. marginatum (2.7%) and R. sanguineus (10.5%) were also recorded. The records of H. aegyptium (0.9%) and R. turanicus (0.9%) were unremarkable. Clinical findings were normal on admission and follow up. The levels of liver enzymes, creatinine phosphokinase, lactate dehydrogenase, bleeding markers and complete blood count were normal. No CCHF infection was detected among the children admitted for tick bite.Conclusion: Tick bites and CCHF are important public health problems and it is crucial to publish information on tick bite prevention, which would play an important role in reducing the incidence of direct parasitic contact and the occurrence of transmittable diseases.Publication Evaluation of children with arthritis: 9 years retrospectif study(Galenos Yayınevi, 2020-08-01) Yeşil, Edanur; Çelebi, Solmaz; Özcan, Nur; Özer, Arife; Turan, Cansu; Bülbül, Beyhan; Ermutlu, Cenk; Sarısözen, Bartu; Hacımustafaoğlu, Mustafa; YEŞİL, EDANUR; ÇELEBİ, SOLMAZ; Özcan, Nur; Özer, Arife; TURAN, CANSU; BÜLBÜL, BEYHAN; ERMUTLU, CENK; SARISÖZEN, MEHMET BARTU; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 0000-0002-8926-9959; 0000-0003-3146-6391; 0000-0002-5720-1212; 0000-0003-4071-8052; 0000-0003-4646-660X; GSO-3630-2022; AEQ-5464-2022; JCD-9679-2023; ENK-4130-2022; JRU-9977-2023; DLB-3888-2022; IVB-4013-2023; GAX-3172-2022; ABI-7283-2020; CTG-5805-2022INTRODUCTION: The aim of this study was to evaluate the clinical and laboratory findings and treatment responses of patients with arthritis.MATERIALS and METHODS: The medical records of 111 children (0-18 years) were evaluated who were hospitalized with the diagnosis of arthritis between January 2010 and January 2019 retrospectively. The aim of this study was to evaluate the clinical and laboratory findings and to investigate the treatment and prognostic features of the patients.RESULTS: : A total of 111 patients, 66% were male and the mean age was 91+56 (median 83,1-215) months. The most of the patients (n=62,56%) were between 3-10 years of age. Septic arthritis was diagnosed in 60% (n=67) of the patients. This diagnosis was followed by reactive arthritis (10%), juvenile idiopathic arthritis (10%), toxic/transient synovitis (5%) and other arthritis. On admission, there were pain in 96%, joint swelling in 63%, redness in 21%, increased temperature of the joint in 41%, decreased range of motion in 64%, and inability to walk in 38% of the patients. The most frequently involved joints were knee (51%) and hip (35%). The possibility of septic arthritis was significantly higher in patients with high fever (p=0,0001). The response to ibuprofen was higher in non-septic arthritis (p=0,0001). Arthrocentesis was performed in 55% (n=61) of the cases and 34% (n=38) of the patients had underwent intra-articular debridement surgery. Staphylococcus aureus and Streptococcus pyogenes were the most common microorganisms growth in joint fluid culture. When septic arthritis and other arthritis cases were compared, the effusion amount, the amount of fluid taken by puncture were significantly higher and the level of CRP and leukocytes were higher in septic arthritis group (p=0,001;p=0,025;p=0,018;p=0,032,respectively). Osteomyelitis was observed in 19%(n=21) of the cases.CONCLUSIONS: In this study, the probability of septic arthritis was found to be statistically significant in patients with fever, leukocyte>12100/mm(3), CRP>3 mg/dl, and effusion measured 8.5 mm or more by ultrasonography. Also, ibuprofen response was higher in non-septic arthritis group.Publication Evaluation of children with tuberculosis: A 10-year retrospective study(Galenos Publishing House, 2022-12) Yeşil, Edanur; Sezer, Çisel; Çelebi, Solmaz; Turan, Cansu; Bülbül, Beyhan; Hacımustafaoğlu, Mustafa; SEZER, ÇİSEL; ÇELEBİ, SOLMAZ; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı; 0000-0002-3928-3453; 0000-0002-3536-0263; 0000-0003-4646-660X; FVE-4013-2022; JHN-1091-2023; CTG-5805-2022Introduction: Childhood tuberculosis is a perspective that adult tuberculosis is not well controlled in the community. In this study, it was aimed to evaluate the epidemiological and clinical data of the cases we followed up with the diagnosis of tuberculosis.Materials and Methods: The clinical data of the cases who admitted to the Pediatric Infection Clinic and Outpatient Clinic of our hospital between 2010 and 2020 and were diagnosed with tuberculosis were retrospectively analyzed. Approval for the study was obtained from the Ethics Committee of Uludag University Medical Faculty with the decision no. 2020-5/3.Results: The mean age of 175 cases was 125 +/- 66,038 (median 132, 3-216) months, and 51% were female. 88% of the cases (n=154) live in Bursa and the majority of the admissions are from Osmangazi (n=41, 23.4%), Yildirim (n=40, 22.9%), Inegol (n=20, 11.5%) and Nilufer (n=19, 10.9%). Pulmonary tuberculosis was seen in 55% (n=96) of the cases, extrapulmonary tuberculosis in 42% (n=74), and pulmonary and extrapulmonary tuberculosis in 3% (n=5). 25.7% (n=45) of all cases had a history of contact with tuberculosis. 6.3% (n=11) of the cases had a history of taking prophylaxis before. Cough in 46% (n=81) of cases, fever in 29% (n=50), weight loss in 14% (n=24), night sweats in 13% (n=22), 5% (n=8) had complaints of hemoptysis. The mean sedimentation value of the cases was 36 +/- 28.85 (median 27. 5-140) mm/hour, and the mean CRP value was 16 +/- 41.94 (median 1. 1-258) mg/L. The tuberculin skin test was positive in 65% (n=114) of the cases. Mycobacter ARB (acid-resistant bacillus) was positive in 19% (n=27) and culture was positive in 18% (n=25) of the cases evaluated microbiologically (n=142). PCR was positive in 45% (n=47) of the 104 cases in which mycobacterial PCR was examined. Side effects were observed in 11% of the cases, and hepatotoxicity was observed most frequently (n=11, 6.3%). One patient died in the seventh month of treatment due to complications related to cystic fibrosis.Conclusion: Tuberculosis is a highly contagious disease caused by Mycobacterium tuberculosis and may result in mortality if left untreated. In this study, culture positivity was found to be 18%, and the most common side effect was hepatotoxicity.Publication Evaluation of micafungin use in children(Ankara Microbiology, 2020-01-01) Hacimustafaoglu, Mustafa; Yeşil, Edanur; YEŞİL, EDANUR; Çelebi, Solmaz; ÇELEBİ, SOLMAZ; Sezgin Evim, Melike; SEZGİN EVİM, MELİKE; Özer, Arife; Turan, Cansu; TURAN, CANSU; Timur, Demet; TİMUR, DEMET; Çakır, Salih Cağrı; ÇAKIR, SALİH ÇAĞRI; Bülbül, Beyhan; BÜLBÜL, BEYHAN; Ener, Beyza; ENER, BEYZA; Güneş, Adalet Meral; MERAL GÜNEŞ, ADALET; Koksal, Nilgun; Özkan, Hilal; ÖZKAN, HİLAL; Sevinir, Betul; SEVİNİR, BETÜL BERRİN; Düzcan Kilimci, Duygu; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Onkoloji Anabilim Dalı.; 0000-0002-8926-9959; 0000-0003-3146-6391; 0000-0001-5761-4757; 0000-0002-5720-1212; 0000-0002-3232-7652; 0000-0003-4646-660X; AAG-8523-2021; AEZ-2469-2022; GSO-3630-2022; AAH-1570-2021; HJZ-4508-2023; AAE-6201-2021; AAG-8393-2021; JCD-9679-2023Micafungin is recommended especially in patients with liver and kidney failure and in the presence of other side effects due to antifungals apart from its known priority indications such as invasive candidiasis. The aim of this study was to evaluate the children who have received micafungin treatment. In the study, 125 children who were hospitalized in the pediatric wards and intensive care units of our hospital and had used micafungin between November 2016 and January 2019 were analyzed retrospectively. Clinical data, micafungin indication, blood values on the first and fourth days of the treatment, side effects of the drug and efficacy were evaluated. Sixty percent (75/125) of the patients were male and the mean age of all the patients were 58 +/- 67 (0-215, 30) months. Approximately half of the cases (48%) had malignancy and 13% of them were premature. Sixty-two percent (n= 37) of the malignencies were hematological (27 acute lymphocytic leukemia, nine acute myeloid leukemia, one myelodysplastic syndrome) and 38% (n= 23) were oncological (six neuroblastoma, four Hodgkin lymphoma, two Non-Hodgkin's lymphoma, five sarcomas, one hepatoblastoma, five others) malignencies. The major cause of hospitalization was sepsis (53%). The patients had several risk factors like immunosuppressive therapy (n= 68, 54%), neutropenia (n= 61, 49%), central venous catheter (n= 102, 82%), nasogastric tube (n= 63, 50%), endotracheal intubation tube (n= 49, 39%), urinary catheter (n= 14, 11%) and total parenteral nutrition (n= 81, 65%). Thirteen percent (n= 16) of the cases were post-operative patients. Candida species were cultivated in 97 clinical specimens (blood, endotracheal aspirate, sputum, urine, etc.) among 23 (18%) of the patients. Thirteen (10%) of the patients had candidemia and 62% of them were non-albicans strains. In all candidemias, strains were echinocandin susceptible, and blood cultures were negative within four days. When all the patients (n= 125) were evaluated, a significant decrease in C-reactive protein, an increase in sodium, and a decrease in alanine aminotransferase were observed on the fourth day of micafungin treatment (p< 0.05). A total of 39 (31%) patients underwent various antifungal treatments for median seven (1-60) days prior to micafungin treatment. Fourteen (36%) of these 39 patients, had elevated liver function tests (LFT), 10 (26%) of them had hypokalemia, and five (13%) of them had elevated renal function tests. Ten (26%) patients had antifungal-induced hypokalemia previously; and potassium levels were normalized after micafungin treatment (p= 0.0001). The patients for which micafungin treatment was chosen due to elevated liver function tests (n= 47, 38%), whether the antifungalinduced or not; alanine aminotransferase and aspartate aminotransferase levels were decreased after micafungin treatment (p= 0.0001 and p= 0.0001, respectively). Nineteen (15%) of the patients have died within the first 30 days of micafungin treatment and one of them had candidemia. No micafungin treatment related significant side effects were observed in any of the patients. Our study showed that micafungin could be a safe and effective option in pediatric cases including newborns with high liver and kidney function tests.Publication Healthcare-associated infections in the department of pediatric hematology-oncology; a single center evaluation(Galenos Publishing House, 2024-04) Özdel, Zeynep Gizem Ergün; Çelebi, Solmaz; Güneş, Adalet Meral; Evim, Melike Sezgin; Sevinir, Betül Berrin; Baytan, Birol; Demirkaya, Metin; Köse, Serdal Kenan; Çetin, Benhur; Çelik, Taylan; Salı, Enes; Hacımustafaoğlu, Mustafa; ERGÜN ÖZDEL, ZEYNEP GİZEM; ÇELEBİ, SOLMAZ; MERAL GÜNEŞ, ADALET; SEZGİN EVİM, MELİKE; SEVİNİR, BETÜL BERRİN; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi; H-2691-2017Introduction: With advances in the treatment of Pediatric Hematology -Oncology (PHO) patients, the survival of patients are increasing day by day. However, Healthcare -Associated Infections (HAI) is still a significant cause of mortality and morbidity in this group of patients. This study aimed to evaluate the rates of HAI in patients who were hospitalized in Uludag University Medical Faculty PHO Clinic during the 4 -year study period. Materials and Methods: HAI was diagnosed according to the CDC (Center for Disease Control and Prevention) 2008 criteria. We recorded the number of patients admitted, the number of patients with HAI, the total number of HAI episodes, and the length of stay in hospital. We calculated HAI rate and HAI density (per 1000 patient -days). Results: During the four years, 3069 hospitalizations were recorded in 607 PHO patients (5.05 admissions per patient). 38.6% of the patients were female, and 61.4% male. The mean age was 100.8 +/- 63.6 months. The mean duration of hospitalization was 14 +/- 17.16 days. A total of 232 HAI episodes were recorded in 141 hospitalizations. HAI rate was 7.5%, and HAI density was 5.36/1000 patient -days. Conclusion: The HAI rates in our PHO unit were comparable to those of developed countries and lower than those of developing countries and prior results from our country.Publication Meningitis caused by neisseria meningitidis, hemophilus influenzae type b and streptococcus pneumoniae during 2005-2012 in Turkey a multicenter prospective surveillance study(Taylor & Francis Inc, 2014-09-01) Ceyhan, Mehmet; Gurler, Nezahat; Özsürekci, Yasemin; Keser, Melike; Aycan, Ahmet Emre; Gürbüz, Venhar; Salman, Nuran; Camcıoğlu, Yildiz; Dinleyici, Ener Cağrı; Özkan, Şengül; Şensoy, Gülnar; Belet, Nursen; Alhan, Emre; Uzun, Hakan; Öner, Ahmet Faik; Kurugol, Zafer; Taş, Mehmet Ali; Aygün, Denizmen; Öncel, Eda Karadağ; Çelik, Melda; Yasa, Olcay; Akın, Fatih; Coşkun, Yavuz; Hacimustafaoglu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Celebi, Solmaz; ÇELEBİ, SOLMAZ; Bursa Uludağ Üniversitesi/Tıp FakültesiSuccessful vaccination policies for protection from bacterial meningitis are dependent on determination of the etiology of bacterial meningitis. Cerebrospinal fluid (CSF) samples were obtained prospectively from children from 1 month to <= 18 years of age hospitalized with suspected meningitis, in order to determine the etiology of meningitis in Turkey. DNA evidence of Neisseria meningitidis (N. meningitidis), Streptococcus pneumoniae (S. pneumoniae), and Hemophilus influenzae type b (Hib) was detected using multiplex polymerase chain reaction (PCR). In total, 1452 CSF samples were evaluated and bacterial etiology was determined in 645 (44.4%) cases between 2005 and 2012; N. meningitidis was detected in 333 (51.6%), S. pneumoniae in 195 (30.2%), and Hib in 117 (18.1%) of the PCR positive samples. Of the 333 N. meningitidis positive samples 127 (38.1%) were identified as serogroup W-135, 87 (26.1%) serogroup B, 28 (8.4%) serogroup A and 3 (0.9%) serogroup Y; 88 (26.4%) were non-groupable. As vaccines against the most frequent bacterial isolates in this study are available and licensed, these results highlight the need for broad based protection against meningococcal disease in Turkey.Publication Nosocomial infections in pediatric cancer patients(Aves Yayincilik, Ibrahim Kara, 2012-12-01) Kavurt, Sumru; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; MERAL GÜNEŞ, ADALET; ÇELEBİ, SOLMAZ; Çelebi, Solmaz; Baytan, Birol; Güneş, Adalet Meral; SEVİNİR, BETÜL BERRİN; Sevinir, Betül; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Hemotoloji Bilim Dalı.; Değer Dil Düzenle Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Onkoloji Bilim Dalı.; Değer Dil Düzenle Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Hastalıkları Bilim Dalı.; 0000-0003-4646-660X; 0000-0002-9375-2855; 0000-0002-3232-7652; AAH-1570-2021; AGG-2256-2022Objective: Pediatric cancer patients comprise an important risk group of nosocomial infections (NI) due to long hospital stay, underlying diseases and intensive chemotherapies. The aim of this study was to evaluate NI in the pediatric hemato-oncology clinic over a one year period.Material and Methods: Nosocomial infections in the pediatric hemato-oncology clinic (with 19 beds) were evaluated over a one-year period. Nosocomial infection was defined according to the criteria of the Centers for Disease Control and Prevention (CDC).Results: Nosocomial infections were defined according to the CDC criteria. Of 342 admitted pediatric cancer patients, 44 (12.8%) developed NI. Sixty-eight NI occurred in 44 patients (1.54 NI per patient). The NI rate was found to be 19.8 per 100 discharge, and 15.6 per 1000 patient-days. Gram positive agents comprised 45.6%, Gram negative agents 43.4% and fungi 11% of all culture-positive NI. Of 44 children with NI, 57% (n=25) had acute lymphoblastic leukemia (ALL), 18% (n=8) had non-Hodgkins lymphoma, 9% (n=4) had acute myeloblastic leukemia (AML), 7% (n=3) had neuroblastoma, and 9% (n=4) had other solid tumors. NI was found at a rate of 14.8/ 1000 patient-days, specifically in children with ALL. The average hospital stay of children with NI was 73.6 +/- 53.4 days (median 53). NI was diagnosed on average after 33.9 +/- 28.3 days of hospitalization. Ten of 44 children with HI (22.7%) died. Seventy percent of these patients were in the terminal stage of their illness. The overall mortality rate was 14.7% in 68 cases of NI.Conclusion: Our results reveal that our center has comparable NI and mortality rates and a similar etiologic agent distribution with regard to other developed countries.Publication Nosocomial stenotrophomonas maltophilia infections in children: Results of a 5-year study(Aves Yayincilik, Ibrahim Kara, 2008-09-01) ÇELEBİ, SOLMAZ; Çelebi, Solmaz; Kavurt, Sumru; Hacımustafaoğlu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; 0000-0003-4646-660X; AGG-2256-2022Aim: The aim of this study was to determine the incidence of nosocomial infections, to analyze the risk factors associated with mortality of the patients with Stenotrophomonas maltophilia infections and to evaluate the episodes of S. maltophilia nosocomial infections in pediatric patients.Material and Method: The data of children with positive cultures, who were diagnosed to have nosocomial infection using the Centers for Disease Control and Prevention criteria, were reviewed and only the patients with nosocomial S. maltophilia infection were included in the study.Results: Between January 1, 2003 and December 31, 2007, a total of 1,439 episodes of nosocomial bacterial infections were observed. Culture proven nosocomial infection rate was 14%. During the study period, a total of 28 nosocomial S. maltophilia infection episodes were identified in 28 patients. The mean age of the patients was 25.8+37.1 months (12 days-15 years) and 54% were male. The most frequently seen nosocomial S. maltophilia infections were ventilator-associated pneumonia (VAP) (78.5%), bacteremia (14.3%), bacteremia plus soft tissue infection (3.6%) and meningitis ( 3.6%). Twenty percent of the patients with S. maltophilia bacteremia had soft tissue involvement. Most of the patients (60.7%) were neonates, followed by the pediatric intensive care unit patients (28.6%). Prematurity (53.6%) was the most common underlying condition. Malignancy (40%) was the major underlying disease in the patients with S. maltophilia bacteremia. In this study, risk factors for nosocomial S. maltophilia infections included the underlying disease, prolonged hospitalization, previous therapy with broad-spectrum antibiotics, presence of a central venous catheter, mechanical ventilation and a stay in the intensive care unit. Predisposing factors associated with mortality of the patients with nosocomial S. mal-tophiliainfections were prolonged antibiotic therapy and the presence of urinary catheter (p<0.05). All the S. maltophilia isolates were susceptible to trimetoprim-sulfamethoxazole. In this study, the mortality rate of all children with nosocomial S. maltophilia infections was found to be 28.6%Conclusion: In our patients, VAP was the most common nosocomial S. maltophilia infection and malignancy was the most frequent underlying disease in the patients with nosocomial S. maltophilia bacteremia. Predisposing factors associated with the mortality of patients with nosocomial S. maltophilia infections were prolonged antibiotic therapy and the presence of urinary catheter.Publication Results of the use of micafungin in newborns(Ankara Microbiology Soc, 2019-01-01) Çakır, Salih Çağrı; ÇAKIR, SALİH ÇAĞRI; Çelebi, Solmaz; ÇELEBİ, SOLMAZ; Özkan, Hilal; ÖZKAN, HİLAL; Köksal, Nilgün; Dorum, Bayram Ali; Yeşil, Edanur; YEŞİL, EDANUR; Hacımustafaoğlu, Mustafa; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0001-5761-4757; 0000-0002-2823-8454; 0000-0002-8926-9959; 0000-0003-4646-660X; AAG-8393-2021; AEZ-2469-2022; GSO-3630-2022; HJZ-4508-2023; A-5375-2017; JCD-9679-2023Invasive candidiasis is a common and serious infection in premature newborns. Preventing and treating fungal infections is very important to improve the prognosis of premature infants. Fluconazole and amphotericin B are used as the first choice in the treatment of invasive fungal infections of the newborns. In some cases, fluconazole and amphotericin B cannot be used due to nephrotoxicity, hepatotoxicity or resistant strains. Micafungin, which is among recently developed echinocandins, is the drug of choice in these cases. The use of micafungin in newborns is new and there is a limited experience about the effect of high dose usage in the central nervous system. The aim of this study was to evaluate the electronic files of patients who used micafungin for the treatment of culture-proven or possible invasive fungal infection during their hospital stay in the neonatal intensive care unit during a 24-month period (2016-2017) in the third-level intensive care unit. A total of 15 patients (10 premature and 5 term babies) were included in the study. The mean birth weight of the patients was 1732 +/- 999 g and the mean gestational age was 32.2 +/- 5.8 weeks. All patients had long-term intensive care and increased risk of invasive candidiasis infection. Central venous catheterization and multiple antibiotics usage were the most common risk factors in these patients. The other risk factors included intubation, total parenteral nutritional use and surgical procedure application. Candida species were isolated from the cultures of four patients. Candida species isolated from patients were Candida albicans, Candida glabrata, Candida catenulata, Candida parapsilosis. The mean time for onset of micafungin was 29.9 +/- 16.6 days. Mean duration of micafungin therapy was 22.4 +/- 11.2 days. Eight patients received amphotericin B, three patients received fluconazole therapy and four patients did not receive any antifungal therapy before the onset of micafungin. None of these patients had an abnormal kidney or liver function tests due to micafungin use. As a conclusion, high dose (10 mg/kg/day) micafungin is a safe and effective treatment choice both in the treatment of neonatal culture proven or probable invasive candida infections that were caused by refractory Candida strains, and in the case of nephrotoxicity and hepatotoxicity.Publication Risk factors for respiratory syncytial virus infections in moderate/late premature infants in Turkey: A prospective multicenter epidemiological study(Thieme Medical Publ Inc, 2020-07-13) Özkan, Hilal; Çelebi, Solmaz; Köksal, Nilgün; Hacımustafaoğlu, Mustafa; Koç, Esin; Tezer, Hasan; Çetinkaya, Merih; Cebeci, Burcu; Erdeve, Ömer; Özdemir, Halil; Turkish Neonatal Soc RSV Study Grp; Turkish Pediat Infect Dis Soc RSV; ÖZKAN, HİLAL; ÇELEBİ, SOLMAZ; KÖKSAL, FATMA NİRGÜL; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri bölümü; 0000-0003-1886-8126; GRN-8407-2022; IGT-7005-2023; CZV-1969-2022; CTG-5805-2022Objective Respiratory syncytial virus (RSV) is one of the most prevalent causes of lower respiratory tract infection (LRTI). The primary objective of this study is to provide the risk modelling of confirmed RSV infection in children who were born preterm at 29 to 35 weeks of gestational age and presented with LRTI. Study Design This prospective, multicenter study was performed between October 2015 and March 2017. Premature infants born with gestational age between 29 and 35 weeks that were <= 2 years of age at the beginning of the RSV season and admitted to the hospital with clinical findings of LRTI during the season were included. RSV-positive and -negative infants were compared in terms of demographic features, risk factors, and requirement of hospitalization. Results RSV positive group was lower than RSV negative group and ratio of <= 3 months age at admission was significant higher in RSV (+) group. RSV-positive infants were found to be significantly born during or 3 months prior to RSV season. The rate and duration of hospitalization and need for mechanical ventilation were significantly higher in RSV positive infants. The rate and duration of hospitalization in RSV positive patients was related to the chronological age. Conclusion This study showed that preterm infants with RSV-associated LRTI significantly needed more hospitalization, intensive care admission, and mechanical ventilation. In addition need of hospitalization and duration of hospitalization were significant higher in <= 3 months of age. Therefore, we suggest the importance of palivizumab prophylaxis in infants <= 3 months chronological age, especially during the RSV season.Publication Risk factors for respiratory syncytial virus infections in moderate/late premature infants in Turkey: A prospective multicenter epidemiological study (jul, 10.1055/s-0040-1713928, 2020)(Thieme Medical Publ Inc, 2020-08-13) Hacimustafaoglu, Mustafa; Koç, Esin; Tezer, Hasan; Çetinkaya, Merih; Cebeci, Burcu; Erdeve, Ömer; Özdemir, Halil; Özkan, Hilal; ÖZKAN, HİLAL; Çelebi, Solmaz; ÇELEBİ, SOLMAZ; Köksal, Nilgün; Hacımustafaoğlu, Mustafa; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pediatri Anabilim Dalı.; CTG-5805-2022; CZV-1969-2022; ENK-4130-2022; IGT-7005-2023Publication SARS-CoV-2 seropositivity among pediatric health care personnel after the first peak of the pandemic: Nationwide surveillance in Turkey(Elsevier, 2021-09-22) Oygar, Pembe Derin; Büyükçam, Ayşe; Bal, Zümrüt Şahbudak; Dalgıç, Nazan; Bozdemir, Şefika Elmas; Karbuz, Adem; Çetin, Benhür Şırvan; Kara, Yalçın; Çetin, Ceren; Hatipoğlu, Nevin; Uygun, Hatice; Aygün, Fatma Deniz; Torun, Selda Hançerli; Okur, Dicle Şener; Çiftdoğan, Dilek Yılmaz; Kara, Tuğçe Tural; Yahşi, Aysun; Özer, Arife; Demir, Sevliya Öcal; Akkoç, Gülsen; Turan, Cansu; Salı, Enes; Şen, Semra; Erdeniz, Emine Hafize; Kara, Soner Sertan; Emiroğlu, Melike; Erat, Tuğba; Aktürk, Hacer; Gürlevik, Sibel Laçinel; Sütcü, Murat; Aydın, Zeynep Gökçe Gayretli; Atıkan, Başak Yıldız; Yeşil, Edanur; Güner, Gizem; Çelebi, Emel; Efe, Kadir; İsançlı, Didem Kızmaz; Durmuş, Habibe Selver; Tekeli, Seher; Karaaslan, Ayşe; Bülbül, Lida; Almış, Habip; Kaba, Özge; Keleş, Yıldız Ekemen; Yazıcıoğlu, Bahadır; Oğuz, Şerife Bahtiyar; Ovalı, Hüsnü Fahri; Doğan, Hazal Helin; Çelebi, Solmaz; Çakır, Deniz; Karasulu, Burcugül; Alkan, Gülsüm; Yenidoğan, İrem; Gül, Doruk; Küçükalioğlu, Burcu Parıltan; Avcu, Gülhadiye; Kukul, Musa Gürel; Bilen, Melis; Yaşar, Belma; Üstün, Tuğba; Kılıç, Ömer; Akın, Yasemin; Cebeci, Sinem Oral; Bucak, İbrahim Hakan; Yanartaş, Mehpare Sarı; Şahin, Aslıhan; Arslanoğlu, Sertaç; Elevli, Murat; Çoban, Rabia; Öz, Sadiye Kübra Tüter; Hatipoğlu, Halil; Erkum, İlyas Tolga; Turgut, Mehmet; Demirbuğa, Asuman; Özçelik, Taha; Çiftci, Diclehan; Sarı, Emine Ergül; Akkuş, Gökhan; Hatipoğlu, Sadık Sami; Dinleyici, Ener Çağrı; Hacımustafaoğlu, Mustafa; Özkınay, Ferda; Kuruğol, Zafer; Cengiz, Ali Bülent; Somer, Ayper; Tezer, Hasan; Kara, Ateş; TURAN, CANSU; ÇELEBİ, SOLMAZ; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Anabilim Dalı.; IVB-4013-2023; JHN-1091-2023; CTG-5805-2022Background: 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.Publication The diagnostic value of serum amyloid a in early-onset neonatal sepsis in premature infants(Medcom, 2021-01-01) Dorum, Bayram Ali; Özkan, Hilal; Çakır, Salih Çağrı; Köksal, Nilgün; Gözal, Zeynep; Çelebi, Solmaz; Hacımustafoğlu, Mustafa; Dorum, Bayram Ali; ÖZKAN, HİLAL; ÇAKIR, SALİH ÇAĞRI; Köksal, Nilgün; Gözal, Zeynep; ÇELEBİ, SOLMAZ; Hacımustafoğlu, Mustafa; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Hastalıkları Anailim Dalı/Neonatoloji Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Hastalıkları Anabilim Dalı.; 0000-0002-2823-8454; 0000-0001-5761-4757; AAG-8451-2021; HJZ-4508-2023; A-5375-2017; AEZ-2469-2022; JLX-9286-2023; FFA-6764-2022; CRX-2793-2022; CSN-9445-2022Purpose: In this study, the aim was to determine the distinct effectiveness of serum amyloid A in the early stage of early-onset neonatal sepsis in premature infants. Methods: Preterm newborns hospitalised between 2014 and 2017 for suspected early-onset neonatal sepsis were included in this prospective study. Patients were evaluated according to clinical and laboratory findings at admission and at the 24th and 48th hours after admission. The serum amyloid A values of the patients with sepsis and a control group were compared, and the blood cultures were evaluated. Results: A total of 319 premature newborns were included in the study: 150 in the sepsis group and 169 in the control group. Their birth weight ranged between 590 g and 3000g and the gestational age was 24-36 weeks. The serum amyloid A values at admission were significantly higher in the cases diagnosed with sepsis compared to the control group. Conclusion: Serum amyloid A is a reliable diagnostic marker for the early onset of neonatal sepsis, and it has a higher sensitivity at symptom onset or in the first hours after birth in premature infants.