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    Bacterial agents causing meningitis during 2013–2014 in Turkey: A multi-center hospital-based prospective surveillance study
    (Taylor and Francis Inc., 2016) Ceyhan M.; Ozsurekci Y.; Gürler N.; Karadag Oncel E.; Camcioglu Y.; Salman N.; Celik M.; Emiroglu M.K.; Akin F.; Tezer H.; Parlakay A.O.; Tuygun N.; Tamburaci D.; Dinleyici E.C.; Karbuz A.; Uluca Ü.; Alhan E.; Çay Ü.; Kurugol Z.; Hatipoğlu N.; Şiraneci R.; İnce T.; Sensoy G.; Belet N.; Coskun E.; Yilmaz F.; Hacimustafaoglu M.; Celebi S.; Celik Ü.; Ozen M.; Akaslan A.; Devrim İ.; Kuyucu N.; Öz F.; Bozdemir S.E.; Kara A.
    This is an observational epidemiological study to describe causes of bacterial meningitis among persons between 1 month and 18 y of age who are hospitalized with suspected bacterial meningitis in 7 Turkish regions. covering 32% of the entire population of Turkey. We present here the results from 2013 and 2014. A clinical case with meningitis was defined according to followings: any sign of meningitis including fever, vomiting, headache, and meningeal irritation in children above one year of age and fever without any documented source, impaired consciousness, prostration and seizures in those < 1 y of age. Single tube multiplex PCR assay was performed for the simultaneous identification of bacterial agents. The specific gene targets were ctrA, bex, and ply for N. meningitidis, Hib, and S. pneumoniae, respectively. PCR positive samples were recorded as laboratory-confirmed acute bacterial meningitis. A total of 665 children were hospitalized for suspected acute meningitis. The annual incidences of acute laboratory-confirmed bacterial meningitis were 0.3 cases / 100,000 population in 2013 and 0.9 cases/100,000 in 2014. Of the 94 diagnosed cases of bacterial meningitis by PCR, 85 (90.4%) were meningococcal and 9 (9.6%) were pneumococcal. Hib was not detected in any of the patients. Among meningococcal meningitis, cases of serogroup Y, A, B and W-135 were 2.4% (n = 2), 3.5% (n = 3), 32.9% (n = 28), and 42.4% (n = 36). No serogroup C was detected among meningococcal cases. Successful vaccination policies for protection from bacterial meningitis are dependent on accurate determination of the etiology of bacterial meningitis. Additionally, the epidemiology of meningococcal disease is dynamic and close monitoring of serogroup distribution is comprehensively needed to assess the benefit of adding meningococcal vaccines to the routine immunization program. © 2016 Taylor & Francis.
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    Effectiveness of a new bioequivalent formulation of oseltamivir (Enfluvir ®) on 2010-2011 seasonal influenza viruses: An open phase IV study
    (2012) Ceyhan M.; Karadag Oncel E.; Badur S.; Ciblak M.A.; Alhan E.; Celik U.S.; Kurugol Z.; Saz E.U.; Ozsurekci Y.; Celik M.; Parlakay A.O.
    Objective: The aim of this multicenter prospective study was to evaluate the efficacy of a new bioequivalent formulation of oseltamivir for the treatment of influenza A, influenza B, and H1N1 during the 2010-2011 influenza season. Methods: We compared the symptoms and signs of 300 pediatric patients presenting to three university hospitals with an influenza-like illness between January and March 2011. Nasal swab specimens were collected from all children and tested by reverse-transcription polymerase chain reaction (RT-PCR) for influenza viruses. After randomization, half of the participants were prescribed oseltamivir, while the other half were observed conservatively. Forty patients who were followed-up for influenza prior to the study were also included in the evaluation. Results: Influenza was confirmed by RT-PCR in 129 children, 71 of whom were prescribed oseltamivir. The durations of the symptoms fever, cough, nasal congestion, and rhinorrhea were significantly shorter for patients who were treated with oseltamivir compared with untreated patients (. p<. 0.002 for all symptoms). Early initiation of oseltamivir therapy (within 48. h of the onset of symptoms) was associated with more favorable outcomes and an earlier recovery than in patients for whom treatment was delayed (beyond 48. h). Thirty-seven patients (28.7%) had H1N1, 44 (34.1%) had influenza A, 46 (35.7%) had influenza B, one (0.8%) had H1N1 plus influenza A, and one (0.8%) had influenza A plus influenza B viruses. In the comparison of the duration of symptoms according to the different virus types, a statistically significant difference was only observed in patients with influenza B who had a longer duration of cough (. p<. 0.001), nasal congestion (. p<. 0.001), and rhinorrhea (. p<. 0.001). Conclusions: Oseltamivir is an effective treatment for the management of seasonal influenza and H1N1, and should be initiated immediately without waiting for laboratory confirmation of diagnosis. © 2012 International Society for Infectious Diseases.