Person: KEPENEKLİ KADAYİFCİ, EDA
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KEPENEKLİ KADAYİFCİ
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Publication Open Access Effect of video camera monitoring feedback on hand hygiene compliance in neonatal intensive care unit, an interventional study(2023-01-02) SİLİ, ULUHAN; MEMİŞOĞLU, ASLI; ÖZEK, EREN; KEPENEKLİ KADAYİFCİ, EDA; Bilgin H., SİLİ U., Pazar N., Kucuker I., Kepenekli E., Yanar M. A., MEMİŞOĞLU A., ÖZEK E., Adhikari N. K., Pinto R., et al.Background: The purpose of this study was to determine whether use of a video camera surveillance system for hand hygiene (HH) monitoring, video-based education, and feedback could improve the HH compliance in a neonatal intensive care unit (NICU). Methods and materials: This was an interventional before-after trial conducted in a level-III NICU between July 2019 and June 2020. HH compliance was measured using randomly selected video-camera footage in the baseline, intervention, and maintenance periods. After the baseline, an intervention consisting of feedback and education with video scenarios was implemented. The primary outcome was change in HH compliance. The compliance rates were analyzed as an interrupted time series (ITS) with a segmented regression model adjusted for autocorrelation for each study period. Results: We identified a total of 8335 HH indications. There were non significant increases in the total compliance rate (9.0%, 95% CI -2% to 20%) at the time of intervention and in the compliance rate after intervention (0.26%, 95% CI -0.31% to 0.84%) per day. The hand hygiene compliance before patient contact significantly increased (19.8%, 95% CI, 4.8%-34.8%). Incorrect glove use improved non-significantly with the intervention (-3.4%, 95% CI -13.4% to 6.7%). Conclusion: In this study of HH monitoring using video-camera footage combined with an intervention including feedback and education, there were inconsistent improvements in HH compliance. However, these improvements were not sustained in the long term. Frequent feedback and education may be required to sustain high compliance.Publication Open Access Reduction of nosocomial infections in the intensive care unit using an electronic hand hygiene compliance monitoring system(2021-12-01) GÜL, FETHİ; YAKUT, NURHAYAT; BİLGİLİ, BELİZ; KASAPOĞLU, UMUT SABRİ; ARSLANTAŞ, MUSTAFA KEMAL; KEPENEKLİ KADAYİFCİ, EDA; Akkoc G., Soysal A., GÜL F., KEPENEKLİ KADAYİFCİ E., Arslantas M. K., Yakut N., BİLGİLİ B., Demir S. O., Haliloglu M., Kasapoglu U. S., et al.Introduction: Healthcare-associated infection is an important cause of mortality and morbidity worldwide. Well-regulated infection control and hand hygiene are the most effective methods for preventing healthcare-associated infections. This study evaluated and compared conventional hand hygiene observation and an electronic hand-hygiene recording and reminder system for preventing healthcare-associated infections. Methodology: This pre-and post-intervention study, employed an electronic hand-hygiene recording and reminder system for preventing healthcare-associated infections at a tertiary referral center. Healthcare-associated infection surveillance was recorded in an anesthesia and reanimation intensive care unit from April 2016 to August 2016. Hand-hygiene compliance was observed by conventional observation and an electronic recording and reminder system in two consecutive 2-month periods. healthcare-associated infections were calculated as incidence rate ratios. Results: The rate of healthcare-associated infections in the electronic hand-hygiene recording and reminder system period was significantly decreased compared with that in the conventional hand-hygiene observation period (incidence rate ratio = 0.58; 95% confident interval = 0.33-0.98). Additionally, the rate of central line-associated bloodstream infections and the rate of ventilator-associated pneumonia were lower during the electronic hand hygiene recording and reminder system period (incidence rate ratio= 0.41; 95% confident interval = 0.11-1.30 and incidence rate ratio = 0.67; 95% confident interval = 0.30-1.45, respectively). Conclusions: After implementing the electronic hand hygiene recording and reminder system, we observed a significant decrease in healthcare-associated infections and invasive device-associated infections. These results were encouraging and suggested that electronic hand hygiene reminder and recording systems may reduce some types of healthcare-associated infections in healthcare settings.Publication Open Access Evaluation of infants with HIV-infected mothers and perinatal transmission in Turkey: A single-center experience(KARE PUBL, 2021) KEPENEKLİ KADAYİFCİ, EDA; Yakut, Nurhayat; Kepenekli, EdaOBJECTIVE: The most common route of HIV infection in children is through perinatal transmission. In this study, we aimed to evaluate the characteristics of infants with HIV-infected mothers and perinatal HIV transmission. METHODS: We conducted a retrospective, single-center study of HIV-exposed infants in between December 2017 and October 2019 in a Marmara University Pendik Training and Research Hospital. RESULTS: A total of 18 infants were examined. All babies were born by cesarean section, and none of them were breastfed. Seventeen mothers were diagnosed with HIV before pregnancy. These mothers had received antiretroviral therapy (ART) during pregnancy, and their viral loads before delivery were negative. An antiretroviral prophylaxis with oral zidovudine was started in all infants within their 1st day of birth and continued for at least 6 weeks. All infants were tested for their HIV viral load within the first 48 h of birth, with negative results, and 12 infants were tested for anti-HIV antibodies at the 18th month, again with negative results. In this study, we determined that none of the infants had been infected with HIV. CONCLUSION: Our findings highlight the importance of initiating ART for all HIV-infected pregnant women and the importance of protection modalities during pregnancy, delivery, and the postnatal period for the prevention of perinatal transmission of HIV.Publication Metadata only Ev içi temaslı beş çocuk olguda çoklu ilaca dirençli tüberkülozun yönetimi(2022-03-17) ERDEM ERALP, ELA; GÖKDEMİR, YASEMİN; KEPENEKLİ KADAYİFCİ, EDA; Parlak B., Yılmaz D., Ergenç Z., Yılmaz S., Aslan S., Babalık A., Erdem Eralp E., Gökdemir Y., Kepenekli Kadayifci E.Publication Open Access Healthcare-associated staphylococcus aureus infections in children in Turkey: A six-year retrospective, single-center study(2023-08-01) İLKİ, ZEYNEP ARZU; KEPENEKLİ KADAYİFCİ, EDA; Yakut N., Ergenç Z., Tuncay S. A., Bayraktar S., Sayın E., İlki 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.Publication Metadata only The impact of vitamin B12 deficiency on infant gut microbiota(SPRINGER, 2020) ERZİK, CAN; Boran, Perran; Baris, Hatice Ezgi; Kepenekli, Eda; Erzik, Can; Soysal, Ahmet; Dinh, Duy M.Although physiologic and neurologic consequences of micronutrient deficiencies have been addressed extensively, less is known about their impact on developing gut microbiota. Vitamin B12 deficiency is a common micronutrient deficiency in infants. We aimed to analyze the gut microbial composition of exclusively breastfed infants aged between 4 and 6 months with and without vitamin B12 deficiency by 16S rRNA gene sequencing. In a subgroup of infants with vitamin B12 deficiency, stool samples are recollected and reanalyzed after vitamin B12 supplementation. A total of 88 infants' stool samples (median age 4 months [IQR 4-5], 50% males) were analyzed, of which 28 (31.8%) were vitamin B12 sufficient and 60 (68.2%) were vitamin B12 insufficient. Comparisons between vitamin B12-sufficient and vitamin B12-insufficient infants revealed no evidence of differences in the microbiota. Proteobacteria, Firmicutes, Actinobacteria, and Bacteroidetes were the most abundant phyla in all groups. There was no difference between the pre- and post-treatment composition of gut microbiota. Conclusion: Vitamin B12-deficient infants have similar gut microbial composition as vitamin B12-sufficient infants. Since the samples were collected at an early period of life and the exposure to deficiency was relatively short, it may be possible that the effects were not fully established.Publication Metadata only Antifungal susceptibility, species distribution and risk factors associated with mortality of invasive candidiasis in children in Turkey: A six-year retrospective, single-centre study(MASSON EDITEUR, 2021) KEPENEKLİ KADAYİFCİ, EDA; Yakut, N.; Kepenekli, E.; Ergenc, Z.; Baran, E.; Cerikcioglu, N.Invasive candidiasis (IC) is a life-threatening fungal infection with high morbidity and mortality. In this study, we aimed to investigate the Candida species distribution and antifungal drug susceptibility and to identify the risk factors associated with IC mortality in children. We conducted a retrospective, single-centre study of paediatric IC in patients from a tertiary care hospital in Turkey between January 2013 and February 2019. A total of 56 Candida isolates underwent antifungal susceptibility testing performed by Sensititre YeastOne YO10 panel, and the demographic and clinical data of 65 patients were examined during the study period. The most commonly isolated species was Candida albicans in 30 patients (46%), followed by C. parapsilosis in 25 patients (38%) and C. tropicalis in three patients (5%). According to the antifungal drug susceptibility testing, C. albicans was fully susceptible to fluconazole and the other antifungal agents (100%). None of the isolates displayed resistance to anidulafungin, micafungin, flucytosine, posaconazole, voriconazole or itraconazole. There were low rates of resistance to fluconazole (1.8%), caspofungin (1.8%) and micafungin (1.8%). In addition, 5.3% of the Candida isolates were susceptible in a dose-dependent manner to itraconazole, 3.6% were susceptible to voriconazole and fluconazole and 1.8% were susceptible to anidulafungin. The mortality rate of IC was 15.4%. Thrombocytopenia after IC treatment was significantly associated with mortality in the multivariate analysis. These results, which help determine the species distribution, antifungal susceptibility patterns and risk factors for mortality, could make a significant contribution to the management of these challenging infections, including choosing appropriate empirical antifungal therapy. (C) 2020 Elsevier Masson SAS. All rights reserved.Publication Metadata only Incidence of MIS-C and the Comorbidity Scores in Pediatric COVID-19 Cases(2021) KARAHASAN, AYŞEGÜL; Ergenc, Zeynep; Kepenekli, Eda; Çetin, Ece; Ersoy, Ayşenur; Korkmaz, Billur; Selçik, Raziye; Sarınoglu, Rabia Can; Karahasan, AysegülBACKGROUND: We aimed to determine the incidence of multisystem ınflammatory syndrome in children (MIS-C) in pediatric coronavirus disease 2019 (COVID-19) cases and to define the relationships between the need for hospitalization, the development of MIS-C, and Charlson (CCI) and Pediatric comorbidity index (PCI) scores. METHODS: All pediatric COVID-19 cases between March 25, 2020, and December 28, 2020, in the Marmara University Pendik Training and Research Hospital were enrolled. Patients who needed hospitalization were determined. Hospital records were reexamined to identify those diagnosed as having MIS-C. CCI and PCI were used to validate the comorbidity status. RESULTS: Among 2055 pediatric COVID-19 cases, 1340 were included in the study. Two hundred thirteen patients (15.9%) had at least one comorbidity. All the patients or their parents were interviewed about the need for hospitalization, except for the acute period. Six patients had MIS-C, which corresponds to a MIS-C incidence of 0.4%. The need for hospitalization increased in the patients with comorbidities (p<0.05). No correlation was found between the comorbidity scores and the development of MIS-C. The need for hospitalization increased in the patients with CCI scores of ≥2 and PCI scores of ≥4 (p<0.05). CONCLUSIONS: Our study is the first to examine the incidence of MIS-C, which was 0.4%, by long-term follow-up of pediatric COVID-19 cases and to demonstrate that the CCI and PCI can be used to predict the need for hospitalization and prognosis of pediatric patients with COVID-19.Publication Metadata only Yenidoğan yoğun bakımdaki bebeklerin karbapenem dirençli gram(-) bakterilerle kolonizasyonundaki risklerin incelenmesi(2021-10-06) MEMİŞOĞLU, ASLI; ALTINKANAT GELMEZ, GÜLŞEN; KEPENEKLİ KADAYİFCİ, EDA; AY, NADİYE PINAR; BİLGEN, HÜLYA SELVA; HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; ÖZEK, EREN; YALÇINOĞLU İ., MEMİŞOĞLU A., ALTINKANAT GELMEZ G., TAVİLOĞLU Z. Ş. , ÖZDEMİR H., KEPENEKLİ KADAYİFCİ E., AY N. P. , BİLGEN H. S. , HASDEMİR M. U. , ÖZEK E.Publication Metadata only The role of human bocavirus on respiratory tract infections in children(2023-05-08) İLKİ, ZEYNEP ARZU; ÜLGER, NURVER; KEPENEKLİ KADAYİFCİ, EDA; Aslan Tuncay S., Ergan B., Ergenç Z., Yılmaz S., Parlak B., Canizci Erdem P., Dizi Işık A., İlki Z. A., Ülger N., Kepenekli Kadayifci E.