Browsing by Author "Tezer, Hasan"

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Antifungal Consumption, Indications And Selection Of Antifungal Drugs In Paediatric Tertiary Hospitals in Turkey: Results from The First National Point Prevalence Survey
(2018) Caglar, Ilknur; Devrim, Ilker; Ozdemir, Halil; Sahbudak, Zumrut; Sonmez, Gulsum; Buyukcam, Ayse; Gulhan, Belgin; Kara, Ahu; Aygun, Deniz F.; Bayram, Nuri; Celebi, Solmaz; Cetin, Benhur; Nepesov, Merve, I; Yilmaz, Ayse T.; Kepenekli, Eda; Ciftdogan, Dilek Yilmaz; Acar, Manolya K.; Yayla, Burcu Cura; Okumus, Canan; Ecevit, Zafer; Hatipoglu, Nevin; Kuyucu, Necdet; Kosker, Muhammed; Sen, Semra; Karbuz, Adem; Sutcu, Murat; Duramaz, Burcu Bursal; Ozen, Metehan; Ciftci, Ergin; Alabaz, Derya; Kurugol, Zafer; Kara, Ates; Kanik, Saliha; Kilic, Omer; Oncel, Selim; Somer, Ayper; Tapisiz, Anil; Belet, Nursen; Akcan, Ozge Metin; Turel, Ozden; Ozkaya, Aslinur; Tezer, Hasan; Cengiz, Ali Bulen; Ince, Erdal; Camcioglu, Yildiz; Kocabas, Emine; Arisoy, Emin S.; Salman, Nuran; 30121343
Objectives: The aim of this point prevalence survey was to evaluate the consumption, indications and strategies of antifungal therapy in the paediatric population in Turkey. Methods: A point prevalence study was performed at 25 hospitals. In addition to general data on paediatric units of the institutes, the generic name and indication of antifungal drugs, the presence of fungal isolation and susceptibility patterns, and the presence of galactomannan test and high-resolution computed tomography (HRCT) results were reviewed. Results: A total of 3338 hospitalised patients were evaluated. The number of antifungal drugs prescribed was 314 in 301 patients (9.0%). Antifungal drugs were mostly prescribed in paediatric haematology and oncology (PHO) units (35.2%), followed by neonatal ICUs (NICUs) (19.6%), paediatric services (18.3%), paediatric ICUs (PICUs) (14.6%) and haematopoietic stem cell transplantation (HSCT) units (7.3%). Antifungals were used for prophylaxis in 147 patients (48.8%) and for treatment in 154 patients (50.0%). The antifungal treatment strategy in 154 patients was empirical in 77 (50.0%), diagnostic-driven in 29 (18.8%) and targeted in 48 (31.2%). At the point of decision-making for diagnostic-driven antifungal therapy in 29 patients, HRCT had not been performed in 1 patient (3.4%) and galactomannan test results were not available in 12 patients (41.4%). Thirteen patients (8.4%) were receiving eight different antifungal combination therapies. Conclusion: The majority of antifungal drugs for treatment and prophylaxis were prescribed in PHO and HSCT units (42.5%), followed by ICUs. Thus, antifungal stewardship programmes should mainly focus on these patients within the availability of diagnostic tests of each hospital. (C) 2018 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.
Multi-assay investigation of viral etiology in pediatric central nervous system infections
(2020) Altay-Kocak, Aylin; Bozdayi, Gulendam; Michel, Janine; Polat, Meltem; Kanik-Yuksek, Saliha; Tezer, Hasan; Ozkul, Aykut; Ahmed, Kamruddin; Nitsche, Andreas; Ergunay, Koray; 32683347
Introduction: In an attempt to identify a wide spectrum of viral infections, cerebrospinal fluid (CSF) specimens were collected from pediatric cases with the preliminary diagnosis of viral encephalitis/meningoencephalitis in two reference hospitals, from October 2011 to December 2015. Methodology: A combination of nucleic acid-based assays, including in house generic polymerase chain reaction (PCR) assays for enteroviruses, flaviviruses and phleboviruses, a commercial real-time PCR assay for herpesviruses and a commercial real time multiplex PCR, enabling detection of frequently-observed viral, bacterial and fungal agents were employed for screening. Results: The microbial agent could be characterized in 10 (10%) of the 100 specimens. Viral etiology could be demonstrated in 7 (70%) specimens, which comprises Human Herpesvirus 6 (4/7), Herpes Simplex virus type1 (2/7) and Enteroviruses (1/7). In 3 specimens (30%), Streptococcus pneumoniae, Listeria monocytogenes and Staphylococcus aureus were detected via the multiplex PCR, which were also isolated in bacteriological media. All specimens with detectable viral nucleic acids, as well as unreactive specimens via nucleic acid testing remained negative in bacteriological cultures. Conclusions: Herpes and enteroviruses were identified as the primary causative agents of central nervous system infections in children. Enterovirus testing must be included in the diagnostic work-up of relevant cases.
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.