Browsing by Author "Narli, Nejat"

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    Antibiotic Use in Pediatric and Neonatal Intensive Care Units; Multicenter Point Prevalence Study
    (2014) Tolunay, Orkun; Celik, Umit; Yucel, Gulperi; Celik, Tamer; Mert, Mustafa Kurthan; Resitoglu, Salim; Ozdemir, Ulas; Narli, Nejat; Hanta, Deniz; Yapicioglu, Hacer; Gulcan, Hande; Ozcan, Kenan; Yildizdas, Dincer; Tolunay, Ilknur; Gokay, Naime; Kiraz, Kemal
    Objective: Identifying antibiotic use in pediatric and neonatal intensive care units with a point prevalence study in Adana, Turkey's sixth largest city. Material and Methods: In this point prevalence study, demographic information and antibiotic treatment data were taken on the same day from patients in pediatric and neonatal intensive care units of 6 hospitals located in Adana's city center. Results: Four pediatric intensive care units (two university, one research and training hospital, and one public hospital) and six neonatal intensive care units (two university, one research and training hospital, one public hospital, and two private hospital) were included in the study; 220 patients were at the intensive care units at the time of the study-44 (20%) of the patients were in the pediatric intensive care units, and 176 (80%) of them were at the neonatal intensive care units. Also, 146 (66.4%) of the patients were using antibiotics. The frequency of antibiotic use was 72.7% in the pediatric intensive care units and 64.8% in neonatal intensive care units. There was a pediatric infectious disease physician at the university and research and training hospital. Antibiotic usage was lower (p= 0.002) in clinics where pediatric infectious disease physician consultations could be done. Dual antibiotic combination was applied most frequently. Mostly, ampicillin was preferred at neonatal intensive care units. Clarithromycin was used as a second choice because of seasonal lower respiratory tract infections. Vancomycin was the most preferred antibiotic in pediatric intensive care units, and meropenem and linezolid were the second and third choices. At both intensive care units, use of empiric antibiotic treatment was more frequent. Empiric treatment was applied in 22 (68.7%) patients in the pediatric intensive care units and 95 (83.3%) in neonatal intensive care units. Antibiotics were given to 14.3% of the patients in line with the resulting cultures. Conclusion: Intensive care units are services where antibiotics are used most frequently both in Turkey and in the world. In our opinion, protocols need to be established in clinics, national and international guides should be followed; and pediatric infectious disease physician consultations should be increased in order to reduce the frequency of antibiotic use, inappropriate indications, and inappropriate doses.
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    The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study
    (2021) Demirdag, Tugba Bedir; Koc, Esin; Tezer, Hasan; Oguz, Suna; Satar, Mehme; Saglam, Ozge; Uygun, Saime Sunduz; Onal, Esra; Hirfanoglu, Ibrahim Murat; Tekgunduz, Kadir; Oygur, Nihal; Bulbul, Ali; Zubarioglu, Adil Umut; Ustun, Nuran; Unal, Sezin; Aygun, Canan; Karagol, Belma Saygili; Zenciroglu, Aysegul; Oncel, M. Yekta; Saglik, Adviye Cakil; Okulu, Emel; Terek, Demet; Narli, Nejat; Aliefendioglu, Didem; Gursoy, Tugba; Unal, Sevim; Turkmen, Munevver Kaynak; Narter, Fatma Kaya; Ciftdemir, Nukhet Aladag; Beken, Serdar; Cakir, Salih Cagri; Yigit, Sule; Coban, Asuman; Ecevit, Ayse; Celik, Yalcin; Kulali, Ferit; 0000-0002-2232-8117; 33546932; AAJ-4616-2021
    Background: Healthcare-acquired infections (HAIs) in the neonatal period cause substantial morbidity, mortality, and healthcare costs. Our purpose was to determine the prevalence of HAIs, antimicrobial susceptibility of causative agents, and the adaptivity of the Centres for Disease Control and Prevention (CDC) criteria in neonatal HAI diagnosis. Methods: A HAI point prevalence survey was conducted in the neonatal intensive care units (NICUs) of 31 hospitals from different geographic regions in Turkey. Results: The Point HAI prevalence was 7.6%. Ventilator-associated pneumonia (VAP) and central line-associated bloodstream infections (CLABSI) and late onset sepsis were predominant. The point prevalence of VAP was 2.1%, and the point prevalence of CLABSI was 1.2% in our study. The most common causative agents in HAIs were Gram-negative rods (43.0%), and the most common agent was Klebsiella spp (24.6%); 81.2% of these species were extended spectrum beta-lactamase (ESBL) (& thorn;). Blood culture positivity was seen in 33.3% of samples taken from the umbilical venous catheter, whereas 0.9% of samples of peripherally inserted central catheters (PICCs) were positive. In our study, 60% of patients who had culture positivity in endotracheal aspirate or who had purulent endotracheal secretions did not have any daily FiO2 change (p = 0.67) and also 80% did not have any increase in positive end-expiratory pressure (PEEP) (p = 0.7). On the other hand, 18.1% of patients who had clinical deterioration compatible with VAP did not have endotracheal culture positivity (p = 0.005). Conclusions: Neonatal HAIs are frequent adverse events in district and regional hospitals. This at-risk population should be prioritized for HAI surveillance and prevention programs through improved infection prevention practices, and hand hygiene compliance should be conducted. CDC diagnostic criteria are not sufficient for NICUs. Future studies are warranted for the diagnosis of HAIs in NICUs.