Person: YAKUT, NURHAYAT
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YAKUT
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NURHAYAT
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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 Open Access Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis(HINDAWI LTD, 2016) KEPENEKLİ KADAYİFCİ, EDA; Akkoc, Gulsen; Kadayifci, Eda Kepenekli; Karaaslan, Ayse; Atici, Serkan; Yakut, Nurhayat; Demir, Sevliya Ocal; Soysal, Ahmet; Bakir, AndmustafaEpstein-Barr virus (EBV) usually causes mild, asymptomatic, and self-limited infections in children and adults; however, it may occasionally lead to severe conditions such as neurological diseases, malignant diseases, hepatic failure, and myocarditis. Epstein-Barr virus-related neurological disorders include meningitis, encephalitis, and cranial or peripheral neuritis, which are mostly seen in immunocompromised patients. The therapeutic modalities for EBV-related severe organ damage including central nervous system manifestations are still uncertain. Herein, we describe a seven-year-old boy with EBV encephalitis who presented with prolonged fever, exudative pharyngitis, reduced consciousness, and neck stiffness. Cranial magnetic resonance imaging showed contrast enhancement in the bilateral insular cortex and the right hypothalamus. The diagnosis was made by EBV-DNA amplification in both the blood and cerebrospinal fluid samples. He was discharged with acyclovir therapy without any sequelae.Publication Open Access Bacteremia due to Acinetobacter ursingii in infants: Reports of two cases(AFRICAN FIELD EPIDEMIOLOGY NETWORK-AFENET, 2016) KEPENEKLİ KADAYİFCİ, EDA; Yakut, Nurhayat; Kepenekli, Eda Kadayifci; Karaaslan, Ayse; Atici, Serkan; Akkoc, Gulsen; Demir, Sevliya Ocal; Soysal, Ahmet; Bakir, MustafaAcinetobacter ursingii is an aerobic, gram-negative, opportunistic microorganism which is rarely isolated among Acinetobacter species. We present two immunocompetent infants who developed bacteremia due to A. ursingii. The first patient is a two -month- old boy who had been hospitalized in pediatric surgery unit for suspected tracheo-esophageal fistula because of recurrent aspiration pneumonia unresponsive to antibiotic therapy. The second patient is a fourteen -month- old boy with prolonged vomiting and diarrhea. A. ursingii was isolated from their blood cultures. They were successfully treated with ampicillin-sulbactam. Although A. ursingii has recently been isolated from a clinical specimen; reports of infection with A. ursingii in children are rare. A. ursingii should be kept in mind as an opportunistic microorganism in children.Publication Open Access Hospital acquired Clostridium difficile infection in pediatric wards: a retrospective case-control study(SPRINGER INTERNATIONAL PUBLISHING AG, 2016-12) ÜLGER, NURVER; Karaaslan, Ayse; Soysal, Ahmet; Yakut, Nurhayat; Akkoc, Gulsen; Demir, Sevliya Ocal; Atici, Serkan; Toprak, Nurver Ulger; Soyletir, Guner; Bakir, MustafaBackground: Clostridium difficile is a major cause of antibiotic-associated diarrhea and frequently results in health-care-associated infections. The aim of this study was to determine the incidence and potential risk factors for C. difficile infection (CDI) in hospitalized children who developed diarrhea. A retrospective study was performed at a university hospital in Istanbul over a three-year period (2012-2014). Results: During the study period 12,196 children were hospitalized, among them 986 (8 %) children with diarrhea were investigated for CDI and 100 (0.8 %) children were diagnosed with CDI. The incidence of CDI in hospitalized children was 4/1000, 9/1000 and 9/1000 patients per year in year 2012, 2013 and 2014, respectively (p = 0.008, p < 0.01). The mean age of children with CDI (2.6 +/- 2.6 months) was lower than children without CDI (57.5 +/- 63.5 months) [p = 0.001]. In the multivariate analysis, the presence of underlying chronic diseases [presence of malnutrition (OR 7, 95 % CI 1.33-36.7, p = 0.021), presence of solid organ tumors (OR 6, 95 % CI 2.4-15.7, p < 0.00), presence of congenital heart diseases (OR 4.6, 95 % CI 1.13-18.7, p = 0.03), hospitalization in PICU (OR 15.6, 95 % CI 3.2-75.8, p = 0.001) and hospitalization in hematology and oncology ward (OR 7.8, 95 % CI 2-29.9, p = 0.002)] were found to be independent risk factors for CDI. Conclusion: This is the first description of the incidence and associated risk factors of CDI in Turkish children. One of the most important risk factor was prior antibiotic exposure which emphasizes the importance of antibiotic stewardship programs.Publication Open Access Intravenous Colistin Use for Multidrug-Resistant Gram-Negative Infections in Pediatric Patients(GALENOS YAYINCILIK, 2016-11-30) KEPENEKLİ KADAYİFCİ, EDA; Karaaslan, Ayse; Cagan, Eren; Kadayifci, Eda Kepenekli; Atici, Serkan; Akkoc, Gulsen; Yakut, Nurhayat; Demir, Sevliya Ocal; Soysal, Ahmet; Bakir, MustafaBackground: The emergence of infections due to multidrug-resistant Gram-negative bacilli (MDR-GNB) has led to the resurrection of colistin use. The data on colistin use and drug-related adverse effects in children are scarce. Aims: In this study, we aimed to evaluate the clinical efficacy and safety of colistin use in critically ill pediatric patients. Study Design: This study has a retrospective study design. Methods: Sixty-one critically ill children were identified through the department's patient files archive during the period from January 2011 to November 2014. Results: Twenty-nine females and thirty-two males with a mean +/- standard deviation (SD) age of 61 +/- 9 months (range 0-216, median 12 months) received IV colistin due to MDR-GNB infections. Bacteremia (n=23, 37.7%) was the leading diagnosis, followed by pneumonia (n=19, 31%), clinical sepsis (n=7, 11.4%), wound infection (n=6, 9.8%), urinary tract infection (n=5, 8.1%) and meningitis (n=1, 1.6%). All of the isolates were resistant to carbapenems; however, all were susceptible to colistin. The isolated microorganisms in decreasing order of frequency were: Acinetobacter baumanni (n=27, 44.2%), Pseudomonas aeruginosa (n=17, 27.8%), Klebsiella pneumoniae (n=6, 9.8%), K. pneumoniae and Stenotrophomonas maltophilia (n=1, 1.6%), K. pneumoniae and A. baumanni (n=1, 1.6%), K. oxytoca (n=1, 1.6%) and Enterobacter cloacae (n=1, 1.6%). In seven patients, no microorganisms were detected; however, five of these patients were colonized by carbapenem-resistant K. pneumoniae. The mean duration of colistin therapy was 12 days (range 3-45). Colistin was administered concomitantly with one of the following antibiotics: carbapenem (n=50, % 82), ampicillin-sulbactam (n=5, 8%), quinolones (n=5, 8%), rifampicin (n=1, 1.6%). Carbapenem was the most frequently used antibiotic. Nephrotoxicity was observed in only 1 patient, and we did not observe neurotoxicity in this study. All the patients received intravenous colistin (colisthimethate) at a dosage of 5 mg/kg daily by dividing it in three equal doses. Seven (11.4%) patients died during the study period. Conclusion: Colistin appears to be a safe and efficacious drug for treating MDR-GNB infections in children.Publication Metadata only How safe are children with COVID-19 from cardiac risks? Pediatric risk assesment; insights from echocardiography and electrocardiography(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2021) ŞAYLAN ÇEVİK, BERNA; Cevik, Berna Saylan; Arici, Sule; Ergenc, Zeynep; Kepenekli, Eda; Gunal, Ozge; Yakut, NurhayatBackground/aim: Approximately 40 million individuals worldwide have been infected with SARS-CoV-2, the virus responsible for the novel coronavirus disease-2019 (COVID-19). Despite the current literature about the cardiac effects of COVID-19 in children, more information is required. We aimed to determine both cardiovascular and arrhythmia assessment via electrocardiographic and echocardiographic parameters. Materials and methods: We evaluated seventy children who were hospitalized with COVID-19 infections and seventy children as normal control group through laboratory findings, electrocardiography (ECG), and transthoracic echocardiography (TTE). Results: We observed significantly increased levels of Tp-Te, Tp-Te/QT, and Tp-Te/QTc compared with the control group. Twenty-five of 70 (35.7%) patients had fragmented QRS (fQRS) without increased troponin levels. On the other hand, none of the patients had pathologic corrected QT(QTc) prolongation during the illness or its treatment. On TTE, 20 patients had mild mitral insufficiency, among whom only five had systolic dysfunction (ejection fraction < 55%). There was no significant difference between the patient and control groups, except for isovolumic relaxation time (IVRT) in terms of mean systolic and diastolic function parameters. IVRT of COVID patients was significantly lower than that of control group. Conclusion: Despite all the adult studies, the effects of COVID (R) 19 on myocardial function are not well established in children. The thought that children are less affected by the illness may be a misconception.Publication Open Access Multicenter prospective surveillance study of viral agents causing meningoencephalitis(NATURE RESEARCH, 2021-12) KEPENEKLİ KADAYİFCİ, EDA; Torun, Selda Hancerli; Kaba, Ozge; Yakut, Nurhayat; Kadayifci, Eda Kepenekli; Kara, Manolya; Yanartas, Mehpare Sari; Somer, Ayper; Duramaz, Burcu Bursal; Turel, Ozden; Dalgic, Nazan; Alp, Emel Eksi; Sali, Enes; Cakir, Deniz; Onal, Pinar; Cokugras, Haluk; Aygun, Fatma Deniz; Karbuz, Adem; Onel, Mustafa; Mese, Sevim; Agacfidan, AliThe frequency of bacterial factors causing central nervous system infections has decreased as a result of the development of our national immunization program. In this study, it is aimed to obtain the data of our local surveillance by defining the viral etiology in cases diagnosed with meningoencephalitis for 1 year. Previously healhty 186 children, who applied with findings suggesting viral meningoencephalitis to 8 different tertiary health centers between August 2018 and August 2019, in Istanbul, were included. The cerebrospinal fluid (CSF) sample was evaluated by polymerase chain reaction. The M:F ratio was 1.24 in the patient group, whose age ranged from 1 to 216 months (mean 40.2 +/- 48.7). Viral factor was detected in 26.8%. Enterovirus was the most common agent (24%) and followed by Adenovirus (22%) and HHV type 6 (22%). In the rest of the samples revealed HHV type 7 (10%), EBV (6%), CMV (6%), HSV type 1 (6%), Parvovirus (4%) and VZV (2%). The most common symptoms were fever (79%) and convulsions (45.7%). Antibiotherapy and antiviral therapy was started 48.6% and 4% respectively. Mortality and sequela rate resulted 0.53% and 3.7%, respectively. This highlights the importance of monitoring trends in encephalitis in Turkey with aview to improving pathogen diagnosis for encephalitis and rapidly identifying novel emerging encephalitis-causing pathogens that demand public health action especially in national immunisation programme.Publication Open Access COVID-19 disease characteristics in different pediatric age groups(2022-01-01) ŞENYÜREK, BETÜL; BORAN, PERRAN; KEPENEKLİ KADAYİFCİ, EDA; YAKUT, NURHAYAT; KARAHASAN, AYŞEGÜL; AYDINER, ELİF; MEMİŞOĞLU, ASLI; GÖKDEMİR, YASEMİN; ERDEM ERALP, ELA; KARADAĞ, BÜLENT TANER; KEPENEKLİ KADAYİFCİ E., YAKUT N., Ergenc Z., Aydiner O., Sarinoglu R. C., KARAHASAN A., Karakoc-Aydiner E., MEMİŞOĞLU A., GÖKDEMİR Y., ERDEM ERALP E., et al.Introduction: Little is known about the COVID-19 disease characteristics and differences between different pediatric age groups. This study aimed to investigate the disease characteristics according to age groups. Methodology: We conducted a retrospective, single-center study of pediatric COVID-19 in a tertiary care hospital in Turkey. The patients were divided into three groups: 15 days-24 months old (Group 1), 25-144 months old (Group 2), and 145-210 months old (Group 3) according to age. Results: A total of 139 pediatric patients with COVID-19 were examined. Twenty-nine patients (20.9%) were in Group 1, 52 (37.4%) were in Group 2, 58 (41.7%) were in Group 3. Thirty-nine patients (28.1%) were hospitalized. The most common symptoms were cough (55.4%) and fever (51.8%). The median chest X-ray (CXR) score of hospitalized patients was 1 (min 0-max 7), and the median CXR score of outpatients was 1 (min 0-max 6). Fever was significantly more frequent in Group 1, and chest pain was more frequent in Group 3. Group 1 had significantly higher WBC, lymphocyte, thrombocyte counts, AST, LDH, D-dimer, and Troponin T levels but lower hemoglobin, total protein, and albumin levels. The treatment included antibiotics, oseltamivir, hydroxychloroquine, and supportive therapy. Only one patient (0.7%) received noninvasive mechanical ventilatory support. Conclusions: As we know the clinical course of COVID-19 in children is less severe than in adults. We also found significant differences in both clinical and laboratory findings between different pediatric age groups which supports the theory that disease pathogenesis is highly variable according to age.Publication Open Access Successful treatment of allergic bronchopulmonary aspergillosis with posaconazole in a child with cystic fibrosis: Case report and review of the literature(2020) ERDEM ERALP, ELA; Yakut, Nurhayat; Kadayifci, EdaKepenekli; Eralp, ElaErdem; Gokdemir, Yasemin
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