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İLKİ, ZEYNEP ARZU

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İLKİ

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ZEYNEP ARZU

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2023 - 20242
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    PublicationOpen Access
    Healthcare-associated Staphylococcus aureus infections in children in Turkey: A six-year retrospective, single-center study
    (2023-08-01) SAYIN, ELVAN; İLKİ, ZEYNEP ARZU; KEPENEKLİ KADAYİFCİ, EDA; Yakut N., Ergenc Z., Aslan Tuncay S., Bayraktar S., Sayin E., Ilki Z. A., Kepenekli Kadayifci E.
    Objective: To describe clinical and epidemiological characteristics, antimicrobial susceptibility and mortality-associated factors of healthcare-associated infections (HCAIs) caused by Staphylococcus (S.) aureus in children. Methods: We conducted a retrospective, single-centre study of pediatric HCAIs caused by S. aureus from a tertiary care hospital in Turkey between February 2014 and December 2019. The clinical and epidemiological characteristics and antimicrobial susceptibility of the methicillin-susceptible and methicillin-resistant S. aureus (MSSA and MRSA) isolates was evaluated. Results: A total of 310 pediatric patients were examined. Overall, 225 (72.6%) isolates were MSSA and 85 (27.4%) were MRSA. All S. aureus isolates were susceptible to teicoplanin, vancomycin, linezolid, tigecycline, mupirocin, and daptomycin. Penicillin resistance rates were high (89.0%), while fosfomycin, gentamicin, and clindamycin resistance rates were low (1.3%, 1.0%, and 2.3%, respectively). Except susceptibility to fosfomycin, which was significantly lower in 2014 compared to 2018 and 2019, no significant difference was found in the antimicrobial susceptibility of S. aureus isolates between the years. Baseline characteristics and mortality rate were similar comparing MRSA and MSSA causing HCAIs. The mortality rate of HCAIs caused by S. aureus was 6.5% (20 patients). Malignancy was an independent risk factor associated with mortality in the multivariate analysis (OR 5.446, 95% CI 1.573- 18.849). Conclusions: Our findings demonstrate that MSSA remained the most causative agent of HCAIs caused by S. aureus. The mortality rate was 6.5%, the antibiotic resistance rate was quite high for penicillin and diagnosis of malignancy was the main risk factor for increasing mortality in children. These findings could help improve the management of HCAIs caused by S. aureus in children.
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    PublicationOpen Access
    Prevalence of Norovirus Coinfection in Clostridioides difficile Toxin Positive Patients
    (2024-09-01) SAYIN, ELVAN; İLKİ, ZEYNEP ARZU; Şalcı Aslan H. Ş., Akıllı F. M., Sayın E., İlki Z. A.
    Objective: In this study we aimed to evaluate the prevalence of norovirus genogroups I and II and C.difficile coinfection among patients with gastroenteritis symptoms. Method: A total of 76 patients with diarrhea were included in the study. Of these, 40 are children (<18y), 23 are adults between the ages of 18-65y, and 13 are patients older than 65 years. All these were C.difficile toxin GDH/Toxin A+B (BIOTEC, Spain) positive. In these toxin positive stool samples, Norovirus GI and GII antigen was studied by 2 methods; i.ELISA (R Biopharm, Darmstadt, Germany) and ii.polymerase chain reaction (RT – PCR). We compared the results of the antigen test (ELISA) with those of PCR for the detection of norovirus in stool specimens. SPSS 19.0 statistical program was used to evaluate the data of the research. Results: Out of 76 stool samples tested, 3 (3.9%) were positive for norovirus by ELISA. Subsequent RT-PCR identified norovirus GI and GII in 7 samples (9.2%). Concerning RT-PCR, the sensitivity of the ELISA test was 42.8%, and the specificity was found as 96%. Conclusion: The study identified a 9.2% rate of co-infection with C. difficile and norovirus, with this co-infection being particularly prevalent in children. This finding emphasizes the critical need to consider both co-infection and C. difficile infection as potential causes of diarrhea in hospitalized patients, especially those under 18 or over 65 years old. Keywords: C. difficile, Coinfection, ELISA, Norovirus, PCR