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Öğe The comparison of seroconversion rates among different varicella vaccines administered Turkish children; MAV/06 and vOka(Taylor & Francis Inc, 2021) Umit, Zuhal; Bal, Zumrut Sahbudak; Zeytinoglu, Aysin; Aydogan, Tansu Gulbahar; Bag, Ozlem; Ozenen, Gizem Guner; Ozkinay, FerdaVaricella is a vaccine-preventable disease, and the incidence of varicella has declined since the introduction of varicella vaccine campaigns. A wild type of varicella zoster virus (VZV) was isolated from a 33-month-old child with varicella in Korea in 1989, a different strain (MAV/06). A live-attenuated varicella vaccine containing strain (MAV/06), Suduvax (R), was developed in South Korea in 1994. Turkey introduced the varicella vaccine containing the MAV/06 strain (Varicella Vaccine-GCC, Green Cross, South Korea) in January 2019. Therefore, we aimed to compare the seroconversion rates among MAV/06 vaccine- and vOka-administered children. We prospectively collected blood samples from 98 received vOKA and 98 received MAV/06 children 6 weeks after administration, and seroconversion rates were determined by an indirect fluorescence assay (Anti-VZV IIFT IgG, Euroimmun, Germany). Seroconversion rate was significantly higher in vOka group than MAV/06 group (82.7% vs. 64.3%; p = .004). Of the children vaccinated with vOka strain, 17 children did not develop antibodies, 12 were weakly positive, and the remaining 69 children were strongly positive. Of the children who were administered MAV/06 strain, 35 were negative, 20 were weakly positive, and 43 were strongly positive. In conclusion, this study demonstrated that MAV/06 varicella vaccine had lower seroconversion rates and the strong seropositive cases were less common than vOka-administered children. Larger and prospective studies are needed.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 Fatal Serogroup B Meningococcemia in a Child Previously Vaccinated With MenACWY-DT Vaccine(Sage Publications Inc, 2021) Kurugol, Zafer; Ozenen, Gizem Guner; Bal, Zumrut Sahbudak; Ozkaya, Pinar Yazici; Bilen, Nimet Melis; Umit, Zuhal; Karapinar, Bulent[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 Native valve endocarditis due to Candida albicans in two children: Two new case reports(Wiley, 2019) Guner, Gizem; Bal, Zumrut Sahbudak; Dogan, Eser; Umit, Zuhal; Levent, Erturk; Polat, Suleyha Hilmioglu; Özkınay, Ferda; Kurugol, ZaferCandida endocarditis (CE) is a rare and serious complication of candidemia. Using current diagnostic tools a confirmed diagnosis is often delayed and outcomes remain poor. The majority of new cases occur following cardiac valvular surgery, and/or in patients with the following risk factors: intravenous drug use, cancer chemotherapy, prolonged presence of central venous catheters, and prior history of bacterial endocarditis. It is not a common complication in non-neutropenic patients particularly with the absence of a prosthetic valve, and very few reports in the literature are available. Attempting to add to the limited data, 211 candidemia episodes from 172 nonneutropenic pediatric cases between January 2008 and December 2017 were evaluated. All patients were considered asymptomatic for underlying heart disease. However, 2 (0.9%) patients with a central venous catheter were determined as having endocarditis following echocardiography.Öğe Nosocomial Non-fermentative gram negative bacteria bloodstream infections in children; Risk factors and clinical outcomes of carbapenem resistance(Elsevier, 2021) Ozenen, Gizem Guner; Bal, Zumrut Sahbudak; Umit, Zuhal; Avcu, Gulhadiye; Tekin, Duygu; Kurugol, Zafer; Ozkinay, FerdaIntroduction: Non-fermentative Gram-negative bacterias (NFGNBs) are a major cause of life threatening infections in hospitalized children. in this study, we aimed to evaluate the demographic and clinical characteristics of NFGNBs infections and identify the risk factors and outcomes of bloodstream infections (BSIs) caused by carbapenem-resistant (CR) NFGNBs infections. Methods: A retrospective cohort was designed to evaluate the patients with a BSI caused by NFGNBs between in January 2014 and December 2017. Results: A total of 131 episodes from 115 patients were evaluated. The mean age of the patients was 4.79 +/-(4.74) year. The most commonly isolated NFGNBs species was Acinetobacter spp. (35.9%), Pseudomonas spp. (34.4%), and Stenotrophomonas maltophilia (13%). The rate of carbapenem-resistance was 38.2% in Acinetobacter spp. and 26.6% in Pseudomonas spp. The comparison of CR group with carbapenem-susceptible (CS) group showed statistical significance for the length of hospital stay prior to onset of infection and total hospital stay (P values were 0.001, 0.008). Based on the univariate analysis, requirement of mechanical ventilation, central venous catheter, nasogastric tube, Foley catheter, severe neutropenia (<100/mm3), prolonged neutropenia (>14 days), prior intensive care unit admission and prior antimicrobial treatment (carbapenems, colistin, glycopeptide) were more common in carbapenemresistant NFGNBs infections (P values are 0.001, 0.012, 0.000, 0.005, 0.042, 0.027, 0.007, 0.007). in patients with NFGNBs infections 14-day and 30-day mortality rates were %16.8 and 21.4%. Conclusion: CR infections were more common in children with prolonged and severe neutropenia. Prior antimicrobial use and intensive care unit admission were more common in CR infections. (c) 2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.Öğe Rubella Vaccination and Autism: A Nationwide Cohort Study(Aves Yayincilik, Ibrahim Kara, 2019) Umit, Zuhal[No abstract available]
