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Öğe Clinical Patterns and Seasonal Distribution of Urinary Tract Infection Caused by Extended-spectrum Beta-lactamase-producing Bacteria in Children(Bilimsel Tip Yayinevi, 2021) Tursun, Serkan; Arslan, Zeynep; Alpcan, Ayşegül; Gül, Serdar; Kandur, YaşarIntroduction: Extended-spectrum beta-lactamase-producing Escherichia coli or Klebsiella pneumoniae infections in the pediatric age group are mostly nosocomial infections. This study aimed to investigate the clinical pattern of extended-spectrum beta-lactamase positive urinary tract infection and its seasonal distribution. Materials and Methods: We retrospectively reviewed the medical records of pediatric patients with extended-spectrum beta-lactamases-positive UTI, who were followed-up in our clinic between lune 2015 and lune 2020. Results: One hundred-and-ten patients with ESBL-positive UTI and 231 with non-ESBL UTI were enrolled in this study. The rate of male sex in the ESBL group was significantly lower than that in the non-ESBL group (10.9% vs 27.2%, p= 0.001). The patients with ESBL were older than those in the non-ESBL group (81.3 +/- 49.0 months vs 56.0 +/- 47.2 months, p= 0.001). E. coli was the most iso- lated bacteria in both groups (68% and 70.5%, respectively). The rate of Klebsiella isolation in urine culture was significantly greater in the ESBL group than in the non-ESBL group (p= 0.04). The seasonal distribution of ESBL-positive patients was as follows: spring (18/16.4%), summer (25/22.7%), autumn (25/22.7%), and winter (42/38.2%). Conclusion: There is a substantially high rate of antibiotic resistance among patients with urinary tract infection in developing countries like Turkey. Moreover, we should be aware of the risk of ESBL-positive UTIs, especially in winter.Öğe The clinical and laboratory differences between monosymptomatic and nonmonosymptomatic enuresis(Springer, 2022) Kandur, Yasar; Arslan, Zeynep; Alpcan, Aysegul[Abstract No tAvailable]Öğe The diagnostic value of n-terminal probrain natriuretic peptides to differentiate neonatal pneumoniae and transient tachypnea of the newborn(Tubitak Scientific & Technological Research Council Turkey, 2023) Arslan, Zeynep; Alan, Serdar; Aliefendioglu, DidemBackground/aim: The primary objective of the study was to determine the diagnostic value of serum N-terminal probrain natriuretic peptide (NT-proBNP) levels to differentiate neonatal pneumonia (NP) and transient tachypnea of the newborn (TTN). The secondary objective was to investigate the prognostic role of NT-proBNP levels in neonates with severe respiratory distress (RD). Materials and methods: A prospective, observational, single-blinded study involving 58 late preterm and term newborns who were diagnosed with TTN or NP was conducted between June 2020 and June 2021 at a level-3 neonatal intensive care unit in Kirikkale University Faculty of Medicine. TTN and NP groups were compared for serum NT-proBNP levels measured at the 1st and 24th hours of life. Optimal cut-off NT-proBNP value was determined by Youden index to predict the diagnosis of NP. Lung ultrasound was used to support the diagnosis of TTN and NP. In addition, lung ultrasound score (LUS) was used to determine severe RD. Results: The median of NT-proBNP level was significantly higher at the 24th hour of life in the NP group than in the TTN group, respectively 7263.5 pg/mL (1643-35,000) and 3308 pg/mL (69-19,746), p = 0.004. At a cut-off value of 5515.5 pg/mL, NT-proBNP had a sensitivity of 75% and specificity of 73.8% to predict NP [AUC= 0.749 (95% CI: 0.602-0.895; p = 0.004)]. The study population was divided into two groups as high score group (n: 23, LUS >= 7) and low score group (n: 35, LUS < 7) according to the LUS at the 6th hour of life. NT-proBNP values at 24th hour of life were 6320 pg/mL (69-35,000) in high score group and 3500 pg/mL (570-15,948) in low score group, p = 0.044. Duration of oxygen support (p = 0.006), noninvasive ventilation (p = 0.008) and NICU stay (p = 0.004) were higher in high-score group. Conclusion: NT-proBNP values at 24th hour of life can be used as a relatively early predictor in the differentiation between NP and TTN in late preterm and term neonates. In addition, elevated NT-proBNP values are related to the higher LUS which reflects the severity of RD regardless of diagnosis.Öğe Yenidoğanın geçici takipnesi ve konjenital pnömoni ayırıcı tanısında n-terminal pro-beyin natriüretik peptitin yeri ve önemi(Kırıkkale Üniversitesi, 2021) Arslan, Zeynep; Aliefendioğlu, DidemAMAÇ: Bu çalışmanın amacı, solunum sıkıntısı ile doğan bebeklerde erken dönemde serum N-terminal pro-beyin natriüretik peptitin (NT-proBNP) neonatal pnömoni (NP) ve yenidoğanın geçici takipnesini (YGT) ayırmadaki tanısal gücünü değerlendirmektir. MATERYAL-METOD: Çalışmamız prospektif, gözlemsel olarak Temmuz 2020 ve Temmuz 2021 tarihleri arasında düzenlendi. Gestasyonel yaşı 340/7 ve 410/7 haftalar arasında olan solunum sıkıntısı nedeniyle yenidoğan yoğun bakım ünitesine (YYBÜ) yatırılan bebekler çalışmaya dahil edildi. Hastaların yatışından sonra ilk 6 saat içinde ve postnatal 24-48. saatleri arasında çekilen akciğer ultrason değerleri kaydedilerek akciğer ultrason skoru (AUS) hesaplandı. Kan gazı değerleri, beyaz küre sayısı, trombosit sayısı ve serum NT-proBNP düzeyleri yatışın 1. saati ve postnatal 24. saatlerde; C-reaktif protein ve prokalsitonin düzeyleri postnatal 24. saatinde kaydedildi. BULGULAR: Çalışmaya 42 YGT (%72) ve 16 NP (%28) olmak üzere 58 bebek dahil edildi. Hastaların ortalama gestasyon yaşı 35,0 (34,0-41,0) hafta ve ortalama doğum ağırlığı 2589,7±495,7 gr idi. Yatışın 1. saatinde alınan NT-proBNP serum düzeyi YGT grubu için 1779.5 (359-11639) pg/mL ve NP grubu için 2200 (632-26594) pg/mL idi (p=0.230). İkinci NT-proBNP ise postnatal 24. saatte alındı, ortanca değer YGT grubu için 3308.0 (69-19746) pg/mL ve NP grubu için 7263.5 (1643-35000) pg/mL idi (p=0.004). ROC (Receiver operator characteristics curve) analizi ile NP tanısını öngörmede kullanılabilecek NT-proBNP eşik değeri 5515.5 pg/mL %75 duyarlılık ve %73.8 özgüllük ile anlamlı bulundu. Akciğer ultrason skorlarına göre 7 ve üzeri yüksek skorlu; 6 ve altı düşük skorlu grup olmak üzere karşılaştırdık. Yatışın 1. saatinde bakılan NT-proBNP değeri yüksek skorlu grup için 1870 (547-26594) pg/mL ve düşük skorlu grup için 1219 (359-21300) pg/mL idi (p=0.298). Postnatal 24. saatte bakılan NT-proBNP değerleri ise düşük skorlu grup için 3500 (570-15948) pg/mL ve yüksek skorlu grup için 6320 (69-35000) pg/mL olarak görüldü (p=0.044). SONUÇ: Postnatal 24. saatte bakılan NT-proBNP değeri NP grubunda, YGT grubuna göre daha yüksek görüldü. Ayrıca, tanıdan bağımsız olarak AUS'nın, NT-proBNP değerleri ile korele olduğu saptandı.
