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Öğe Adolescents With Breakthrough COVID-19 Infections Requiring Hospitalization: A Multicenter Retrospective Study(Springernature, 2024) Bal, Zumrut Sahbudak; Arslan, Sema Yildirim; Ozenen, Gizem Guner; Okur, Dicle Sener; Kilicaslan, Onder; Demirbuga, Asuman; Turgut, Elif AfatBackground 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.Öğe Cardiac Assessment in Children with MIS-C: Late Magnetic Resonance Imaging Features(Springer, 2022) Arslan, Sema Yildirim; Bal, Zumrut Sahbudak; Bayraktaroglu, Selen; Ozenen, Gizem Guner; Bilen, Nimet Melis; Levent, Erturk; Ay, OguzhanMultisystem Inflammatory Syndrome (MIS-C) is a new entity that emerges 2-4 weeks after the SARS-CoV-2 infection in children. MIS-C can affect all systems, the most severe of which is cardiac involvement. The duration of the cardiac symptoms is still uncertain and may be persistent or prolonged. The American College of Rheumatology Clinical Guidelines recommends cardiac magnetic resonance imaging (MRI) 2-6 months after the diagnosis of MIS-C in patients presenting with significant transient left ventricular (LV) dysfunction in the acute phase of illness (LV ejection fraction 50%) or persistent LV dysfunction. There are a few studies investigating cardiac MRI findings in MIS-C patients. In this study, we aimed to evaluate cardiac MRI findings, at the earliest 3 months after diagnosis, and compare these findings with the echocardiograms in children with MIS-C. A retrospective study including 34 MIS-C patients was conducted at a tertiary-level University Hospital between June 2020 and July 2021. Centers for Disease Control and Prevention criteria were used in the diagnosis of MIS-C. Cardiac MRI was performed at least 3 months after MIS-C diagnosis. The study included 17 (50%) boys and 17 (50%) girls with a mean age of 9.31 +/- 4.72 years. Initial echocardiographic evaluation revealed cardiac abnormality in 13 (38.2) patients; 4 (11.8%) pericardial effusion, 4 (11.8%) left ventricular ejection fraction (LVEF) < 55%, and 5 (14.7%) coronary artery dilatation. Echocardiography showed normal LV systolic function in all patients during follow-up; coronary dilatation persisted in 2 of 5 (40%) patients at the 6th-month visit. Cardiac MRI was performed in 31 (91.2%) patients, and myocardial hyperemia was not detected in any patients (T1 relaxation time was < 1044 ms in all children). However, 9 (29%) patients' MRI showed isolated elevated T2 levels, and 19 (61.3%) revealed at least one of the following findings: pericardial effusion, right ventricular dysfunction, or LVEF abnormality. In patients with MIS-C, a high rate of cardiac involvement, particularly pericardial effusion was determined by cardiac MRI performed at the earliest 2-6 months after diagnosis. Even if echocardiography does not reveal any abnormality in the initial phase, cardiac MRI should be suggested in MIS-C patients in the late period. This is the first study reporting cardiac MRI findings in the late period of MIS-C patients.Öğe Cervical abscess caused by methicillin-susceptible Staphylococcus aureus in an infant infected with SARS-CoV-2: Diagnostic dilemma(Elsevier, 2021) Arslan, Sema Yildirim; Bal, Zumrut Sahbudak; Ozenen, Gizem Guner; Bilen, Nimet Melis; Kurugol, Zafer; Ozkinay, FerdaA new inflammatory disease has emerged in children after the COVID-19 disease and has been named multisystem inflammatory syndrome in children (MIS-C). We report a case of cervical abscess in an infant with COVID-19 who was first considered to have MIS-C due to persistent fever, high inflammatory markers. A 10-month-old boy was admitted to the emergency department due to a 3-day fever and cervical lymphadenopathy. SARS-CoV-2 RNA was detected by a real-time reverse transcriptase-polymerase chain reaction in the nasopharyngeal swab specimen of the patient. Regarding initial clinical and laboratory findings, the patient was diagnosed to have MIS-C and bacterial co-infection. Clindamycin and ceftriaxone treatments were initiated for bacterial co-infection. Despite treatment, his fever persisted and acute phase reactants compatible with MIS-C were elevated and intravenous immunoglobulin (IVIG) was administered. After IVIG treatment, his fever persisted and the patient developed local inflammatory signs including erythema, tenderness, fluctuation developed. Cervical ultrasonography and magnetic resonance imaging demonstrated the findings compatible with the cervical abscess. Drainage of the cervical abscess was performed by an otolaryngologist. Methicillin-susceptible Staphylococcus aureus was isolated from the abscess culture. After abscess drainage, fever and acute phase reactants declined. His nasopharyngeal swab was negative for SARS-CoV-2 on the 7th day. He was discharged on the 21st day of hospitalization with full recovery. To the best of our knowledge, no cases of COVID-19 with cervical abscess caused by Staphylococcus aureus in children had been reported previously. Bacterial co-infection should be kept in mind in children infected with SARS-CoV-2 and showing MIS-C findings. (c) 2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.Öğe Clinical and Laboratory Findings of SARS-CoV-2 Infection in Children Younger than 6 Months Old: Neutropenia is More Common Not Lymphopenia(Oxford Univ Press, 2022) Ozenen, Gizem Guner; Bal, Zumrut Sahbudak; Bilen, Nimet Melis; Arslan, Sema Yildirim; Ak, Gunes; Koc, Gonca; Cicek, CandanBackground Studies on age-related differences in clinical and laboratory features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are limited. We aimed to evaluate the demographic, clinical, laboratory findings of SARS-CoV-2 infection in children younger than 6 months old and compare them with older children. Methods A single-center retrospective study, including 209 confirmed SARS-CoV-2 infection cases, was conducted between 11 March 2020 and 1 September 2021. The case group consisted of 47 patients younger than 6 months old, whereas the control group consisted of 162 patients older than 6 months old. Results The mean age of the case group was 2.77 +/- 1.52 months, and the control group was 101.89 +/- 65.77 months. Cough was statistically higher in the control group, and poor feeding was higher in the case group (p = 0.043, 0.010). The underlying disease rate was statistically higher in the control group; however, the hospitalization rate was higher in the case group (p = 0.036, 0.001). The case group had significantly lower median values of the absolute neutrophil count, hemoglobin and higher median values of white blood cell, absolute lymphocyte count and platelet than the control group (p < 0.05). C-reactive protein, fibrinogen values were significantly lower, and procalcitonin, D-dimer, troponin T, N-terminal pro-B-type natriuretic peptide significantly higher in the case group (p < 0.05). Lymphopenia was more common in the control group, whereas neutropenia was more common in the case group (p = 0.001, 0.011). Conclusions We showed that most children younger than 6 months old had mild and asymptomatic SARS-CoV-2 infection; however, the hospitalization rate was higher, and neutropenia was more common in older children. Lay summary Studies on age-related differences in clinical and laboratory features on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pediatric patients are limited. We aimed to evaluate the demographic, clinical and laboratory findings of SARS-CoV-2 infection in children younger than 6 months old and compare them with older children. A single-center retrospective study was conducted, including 209 SARS-CoV-2 infection cases. The case group consisted of 47 patients younger than 6 months old, and the control group consisted of 162 patients older than 6 months old. Most children younger than 6 months old had mild and asymptomatic SARS-CoV-2 infection; however, the hospitalization rate was higher than older children. Neutropenia was more common in patients younger than 6 months than older children with SARS-CoV-2 infection, even if underlying diseases were excluded.Öğe Crimean-Congo Hemorrhagic Fever Mimicking Multisystem Inflammatory Syndrome in Children Associated With COVID-19: A Diagnostic Challenge(Lippincott Williams & Wilkins, 2021) Ozenen, Gizem Guner; Bal, Zumrut Sahbudak; Bilen, Nimet Melis; Arslan, Sema Yildirim; Aydemir, Sohret; Kurugol, Zafer; Ozkinay, Ferda[No Abstract Available]Öğe Demographic, clinical, and laboratory features of COVID-19 in children: The role of mean platelet volume in predicting hospitalization and severity(Wiley, 2021) Ozenen, Gizem Guner; Bal, Zumrut Sahbudak; Umit, Zuhal; Bilen, Nimet Melis; Arslan, Sema Yildirim; Yurtseven, Ali; Ozkinay, FerdaThere have been a limited number of studies on coronavirus disease 2019 (COVID-19) in children. in this study, we aimed to investigate the demographic, clinical, and laboratory features of COVID-19 and to identify the role of mean platelet volume (MPV) in predicting the prognosis in children. A single-center retrospective study, including 251 confirmed and 65 suspected COVID-19 cases, was conducted between March 11, 2020, and December 11, 2020. in the confirmed COVID-19 group, 48 (19.1%) patients were asymptomatic, 183 (72.9%) mild, 16 (6.4%) moderate, 1 (0.4%) severe, and 3 were (1.2%) critically ill. Confirmed COVID-19 patients had significantly lower mean values of white blood cell (WBC), absolute neutrophil count, absolute lymphocyte count, platelet, and hemoglobin (p < .001). However, there was no significant difference in MPV levels between the two groups (p = .894). C-reactive protein (CRP), procalcitonin, fibrinogen, and NT-pro-BNP mean values were significantly lower in confirmed COVID-19 cases than suspected cases (p < .001). A total of 55 (21.9%) patients required hospitalization due to COVID-19, and MPV, WBC, CRP, procalcitonin, D-dimer, and NT-pro-BNP were statistically higher in hospitalized patients than those in outpatients. The multivariate analysis of confirmed COVID-19 cases according to the severity of disease showed that lymphopenia and higher levels of fibrinogen significantly associated with severe clinical symptoms. Decision tree analysis showed that the most powerful predictor of hospitalization due to COVID-19 was the D-dimer (p < .001). MPV values are not associated with COVID-19 disease severity. However, MPV can be used with other parameters such as WBC, CRP, procalcitonin, D-dimer, and NT-pro-BNP to predict hospitalization.Öğe Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome secondary to antimicrobial therapy in pediatric bone and infections(Elsevier, 2024) Arslan, Sema Yildirim; Bal, Zumrut Sahbudak; Ozenen, Gizem Guner; Bilen, Nimet Melis; Avcu, Gulhadiye; Erci, Ece; Kurugol, ZaferBackground: Bone and joint infections are common in children, particularly those under 10 years of age. While antimicrobial therapy can often successfully treat these infections, surgical drainage may also be necessary. It is important to note that prolonged courses of treatment have been associated with adverse events and drug reactions. Among these, drug reactions with eosinophilia and systemic symptoms (DRESS) syndrome is particularly severe and potentially life -threatening. We aimed to evaluate the cases of DRESS syndrome that develop during the treatment of bone and joint infections. Methods: A retrospective study was conducted at a tertiary -level university hospital between 2015 and 2022 to determine the incidence and outcomes of definite DRESS Syndrome in children under 18 years of age with bone and joint infections. Results: Of 73 patients with bone and joint infections, 16 (21.9 %) children developed antimicrobial therapy -induced DRESS syndrome. Eight (50 %) of these children were boys; the mean age of the patients was 9.76 +/- 5.5 years. DRESS syndrome occurred in 16 children, including 13 children with osteomyelitis, 1 child with osteomyelitis and septic arthritis, and 2 children with septic arthritis and sacroiliitis. The mean duration of intravenous antibiotic therapy was 40.6 +/- 16.6 days; the mean hospital stay was 48.7 +/- 23.7 days; the mean time for the development of DRESS syndrome after starting antibiotics was 19.6 +/- 7.68 days. New onset fever (68.8 %) and rash (43.8 %) were the most common symptoms of DRESS Syndrome. Cefotaxime and vancomycin were drugs responsible for DRESS syndrome in 8 (50 %) of 16. The causative antibiotics were switched to another class of antibiotic, most commonly preferred was ciprofloxacin (n:5; 31.3 %). For children with persistent symptoms, steroids were used in 5 (31.25) patients. Conclusions: Clinicians should be aware of DRESS syndrome in children who develop fever and rash under long-term antibiotics and should check hematological and biochemical parameters to predict the severity of DRESS syndrome. In patients with persistent symptoms, steroids may be used to control the symptoms.Öğe The Evaluation of the Diagnostic Performance of the BioFire FilmArray Meningitis/Encephalitis Panel in Children: A Retrospective Multicenter Study(Georg Thieme Verlag Kg, 2022) Bal, Alkan; Saz, Eylem Ulas; Arslan, Sema Yildirim; Atik, Sinem; Bayturan, Semra; Yurtseven, Ali; Gazi, HoruObjective 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.Öğe The First Report of Chryseobacterium gleum Caused Ventriculoperitonealshunt Infection in a Child(Lippincott Williams & Wilkins, 2023) Arslan, Sema Yildirim; Bal, Zumrut Sahbudak; Erci, Ece; Arslan, Asli; Avcu, Gulhadiye; Bilen, Nimet Melis; Akbulut, Bahadir[No abstract available]Öğe The First Report of Sphingomonas yanoikuyae as a Human Pathogen in a Child With a Central Nervous System Infection(Lippincott Williams & Wilkins, 2021) Ozenen, Gizem Guner; Bal, Zumrut Sahbudak; Bilen, Nimet Melis; Arslan, Sema Yildirim; Aydemir, Sohret; Kurugol, Zafer; Ozkinay, Ferda[No Abstract Available]Öğe The identification of risk factors and outcomes of cerebrospinal fluid shunt infections caused by carbapenem-resistant gram-negative bacteria in children: a retrospective cohort(Amer Assoc Neurological Surgeons, 2024) Ozenen, Gizem Guner; Bal, Zumrut Sahbudak; Bolat, Elif; Umit, Zuhal; Bilen, Nimet M.; Arslan, Sema Yildirim; Turhan, TuncerOBJECTIVE Cerebrospinal fluid (CSF) shunt infections caused by gram-negative bacteria are difficult to treat given the limited treatment options and the emergence of carbapenem-resistant (CR) strains. This study aimed to evaluate the demographic and clinical characteristics of children with CSF shunt and external ventricular drain (EVD) infections caused by gram-negative bacteria, to identify the risk factors for acquiring CR CSF shunt infections, and to report on the clinical outcomes of these infections. METHODS A retrospective cohort study was designed to evaluate pediatric patients with CSF shunt and EVD infections caused by gram-negative bacteria between January 2013 and February 2023. RESULTS A total of 64 episodes in 50 patients were evaluated. There were 45 (70.3%) CSF shunt infections and 19 (29.7%) EVD infections. The median (range) ages were 1.4 years (9 months-17.5 years) for CSF shunt infection patients and 4.2 years (1 month-17 years) for EVD infection patients. The most common isolated gram-negative bacteria species in CSF shunt infections were Pseudomonas spp. (12, 26.7%), followed by Escherichia coli (11, 24.4%), Klebsiella pneumoniae (9, 20%), and Enterobacter cloacae (5, 11.1%). In EVD infections, the most common isolated gram-negative bacteria species were Acinetobacter spp. (6, 31.6%), followed by Pseudomonas spp. (4, 21.1%) and E. coli (3, 15.8%). The carbapenem resistance rate was 26.3% (n = 5) in EVD infections and 26.2% (n = 11) in CSF shunt infections. When risk factors for carbapenem resistance were evaluated for CSF shunt infections, prior carbapenem treatment and a prolonged hospital stay > 7 days were risk factors for the CR group (p = 0.032 and p = 0.042, respectively). In definitive treatment, colistin was statistically more commonly used in the CR group (p = 0.049). When outcomes were evaluated, the 30-day mortality rate (18.2% vs 0%) was higher in the CR group, without a significant difference (p = 0.064). CONCLUSIONS A prolonged hospital stay > 7 days and prior carbapenem exposure within 30 days were associated with CR shunt infections caused by gram-negative bacteria.Öğe The longitudinal evaluation of COVID-19 in pediatric patients and the impact of delta variant(Oxford Univ Press, 2022) Arslan, Asli; Bal, Zumrut Sahbudak; Arslan, Sema Yildirim; Bilen, Nimet Melis; Ozenen, Gizem Guner; Ozkaya, Pinar Yazici; Yurtseven, AliBackground Pediatric patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) displayed milder symptoms than adults. However, they play an important role in case numbers and virus transmission. Therefore, we aimed to determine the epidemiological features of all pediatric patients infected with SARS-CoV-2 and put forth case numbers longitudinally throughout the delta variant dominant period. Methods A retrospective study was conducted at a university hospital and included patients between 0 and18 years old with a SARS-CoV-2 polymerase chain reaction (PCR) positive result, including inpatients and outpatients. Epidemiological and clinical features were recorded from electronic files, and telephone visits were performed between March 2020 and December 2021. Results During the study period, 3175 coronavirus disease 2019 (COVID-19) pediatric patients were admitted to our hospital with a mean age of 10.61 +/- 4.6 years. Of the 1815 patients who could be interviewed, 85.7% reported at least one symptom. Before the delta variant period, 0-4 years aged children were more commonly infected, while school-aged children and adolescents were more common, and the rate of pediatric cases to all COVID-19 cases increased to 35.8% after the delta variant became dominant. Symptomatic cases were significantly higher before the delta variant (87.8% vs. 84.06%, p = 0.016). The hospitalization rate was higher before the delta variant (p < 0.001), whereas PICU admission showed no statistical difference. Conclusions The frequency of school-aged children and adolescents raised with the impact of both school openings and the delta variant, and the rate of pediatric cases increased in total COVID-19 patient numbers.Öğe Multisystem Inflammatory Syndrome in Children Presenting With Pseudotumor Cerebri and a Review of the Literature(Lippincott Williams & Wilkins, 2021) Bilen, Nimet Melis; Bal, Zumrut Sahbudak; Arslan, Sema Yildirim; Kanmaz, Seda; Kurugol, Zafer; Ozkinay, FerdaMultisystem inflammatory syndrome in children (MIS-C) is a rare but life-threatening inflammatory immune response associated with severe acute respiratory syndrome coronavirus 2 infection. The majority of patients have been presented with hypotension, shock, gastrointestinal, cardiovascular and mucocutaneous symptoms. The incidence of neurologic symptoms in MIS-C is of rising concern as they are not well described and reported in fewer patients. An 8-year-old boy was admitted to the hospital with headache, fever, conjunctivitis, and hyperinflammatory findings diagnosed as MIS-C. Fundus examination performed with complaints of headache, vomiting, and conjunctivitis showed bilateral papilledema. Pseudotumor cerebri is a rare manifestation of MIS-C that can lead to vision loss and may not only be resolved with the standard treatment for MIS-C. We report a case of MIS-C presented with neurologic symptoms due to pseudotumor cerebri and successfully treated with intravenous immunoglobulin and acetazolamide.Öğe The Role of Hematological Parameters in Children with COVID-19, MIS- C, and Other Viral Infections(Galenos Publ House, 2023) Arslan, Sema Yildirim; Bal, Zumrut Sahbudak; Ozenen, Gizem Guner; Bilen, Nimet Melis; Ozkaya, Pinar Yazici; Ozkinay, Ferda; Karapinar, BulentObjective: It is known that coronavirus disease-2019 (COVID-19) showed a clinical course with milder symptoms in children than in adults. However, a multisystem inflammatory syndrome in children (MIS-C), which developed 2-4 weeks after COVID-19 infection, emerged in April 2021. Other respiratory viruses such as influenza, respiratory syncytial virus, and parainfluenza spread worldwide after loosening pandemic restrictions. Pediatricians were challenged to distinguish COVID-19, MIS-C, and other viral infections from each other. Herein, we have aimed to determine basic, simple hematological parameters that can predict the prognosis and outcomes of the patients with COVID-19 and MIS-C. Method: In this study, 300 pediatric inpatients including those with MIS-C, COVID-19, and other respiratory virus infections admitted to Ege University Faculty of Medicine between January 2018 and September 2021, were retrospectively evaluated. Results: The neutrophil-to-lymphocyte ratio (NLR), neutrophil- to-monocyte ratio (NMR), derived NLR, and the systemic inflammatory index were higher in the MIS- C patients compared to others. The lymphocyte-to-monocyte ratio (LMR) and platelet- to-lymphocyte ratio ( PLR) were lower in children with COVID- 19 disease than those with MIS-C (p<0.05). Conclusions: In this study, we have shown that commonly used hematological tests, especially higher values of NLR, NMR for children with MIS- C, and lower levels of LMR for children with COVID-19, are significant and can help to determine the possible disease course of children at an early stage.Öğe Sepsis associated acute kidney injury in pediatric intensive care unit(Wiley, 2022) Ozkaya, Pinar Yazici; Taner, Sevgin; Ersayoglu, Irem; Turan, Benay; Arslan, Sema Yildirim; Karapinar, Bulent; Bulut, Ipek KaplanBackground We aimed to compare the acute kidney injury (AKI) incidence in pediatric septic shock patients according to the three different classifications. Methods We analyzed retrospectively 52 patients with severe sepsis between January 2019 and December 2019. Results While 21 patients have been diagnosed with SA-AKI according to the pRIFLE criteria, 20 children have been diagnosed according to the AKIN criteria, and 21 children have been diagnosed according to the KDIGO criteria. Older age, lower platelet count were determined as independently risk factor for SA-AKI. Older age and higher PRISM score were associated with mortality. According to Canonical correlation coefficients, pRIFLE is the most successful classification to distinguish AKI state. The canonical correlation coefficients for pRIFLE, KDIGO, and AKIN were 0.817, 0.648, and 0.615, respectively. Conclusion Although AKI incidence was similar between the three classifications, pRIFLE was the most successful classification to distinguish AKI state.
