Browsing by Author "Kavurt, Sumru"
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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.Item Transfusion-associated graft-versus-host disease in severe combined immunodeciency(Esmon Publicidad, 2010) Kılıç, Sara Şebnem; Kavurt, Sumru; Adım, Şaduman Balaban; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Tıbbi Patoloji Anabilim Dalı.; 0000-0001-8571-2581; AAH-1658-2021; 34975059200; 36127402300; 15730076300Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare complication of cellular blood component transfusion that produces a graft-versus-host clinical picture with concomitant bone marrow aplasia. We report the case of 2 patients with severe combined immunodeficiency (SCID) who developed TA-GvHD. Both patients had been given nonirradiated erythrocyte suspension before the diagnosis of SCID. Although one of them was aged 12 months, he had still not been diagnosed as having severe T-cell deficiency at the time of transfusion. Both patients presented similar signs and symptoms (fever, skin rash, diarrhea, pancytopenia, and icterus). Skin biopsies demonstrated Grade II GVHD involvement. In both cases, sepsis and septic shock developed, with progression to multiorgan failure. Unfortunately, the 2 patients died, despite prompt, appropriate sepsis treatment and immunomodulatory therapy. TA-GVHD must be considered in the differential diagnosis of patients who present fever, pancytopenia, diarrhea, skin rash and icterus, and the transfusion history must be questioned.Item Yenidoğan ve yenidoğan yoğun bakım servisinde hastane enfeksiyonları(Galenos Yayıncılık, 2011-11) Kavurt, Sumru; Hacımustafaoğlu, Mustafa Kemal; Çelebi, Solmaz; Köksal, Nilgün; Özkan, Hilal; Çetinkaya, Merih; Özkaya, Güven; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Yenidoğan Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; A-4421-2016; 6602154166; 7006095295; 7003323615; 16679325400; 23994946300; 16316866500Aim: Nosocomial infections (NI) in a neonatal intensive care unit (NICU) and neonatal clinic were evaluated during a one-year-period. Material and Method: 314 newborns were investigated for nosocomial infections. Local ethics committee approval was given for this study. Nosocomial infections was defined using the CDC criteria. Results: Nosocomial infections developed in 53% of 127 patients (58% with culture positivity) in the NICU and in 2.6% of 187 patients (all with a negative culture) in the neonatal clinic. In total, (NICU plus neonatal clinic), NI developed in 23% of hosptalized patients. Nosocomial infections rate was 42.3% and in terms of patient days, NI rate was 14/1000 patient-day. When evaluated separately, NI developed in 53.5% of patients admitted in NICU and in 2.6% of neonatal clinic patients. Also, NI rates were 17.9/1000 patient-day in NICU and 1.6/1000 patient-day in the neonatal clinic. Patients with NI stayed at the hospital for 73.6 +/- 47.8 day in NICU and for 16.0 +/- 6.7 day in the neonatal clinic. Nosocomial infections developed on the 29.4 +/- 30.9(th) d in NICU and on the 7.6 +/- 2.9(th) day in the neonatal clinic. In NICU, in terms of 128 NI episodes, the NI related mortality was 8.5%. 16.1% (n: 11) of the patients with NI died. They died on the 56.7 +/- 50.2(nd) day of admission and on the 25.8 +/- 10.2(nd) day second after NI diagnosis. There was no mortality in neonatal clinic patients. Conclusions: Our NI rates were slightly higher than the developed countries and lower than the developing countries.