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Öğe Accompanying Infections in Hospitalized Children with Neurological Disease(Galenos Publ House, 2022) Cokyaman, Turgay; Kasap, Tolga; Celik, TaylanIntroduction: Infections in children with neurological disease often require hospitalization and are treated with antibiotics. In this study, it was aimed to determine the accompanying infections, antibiotics used and pathogenic microorganisms grown in cultures in hospitalized children with neurological disease. Materials and Methods: Digital medical files of patients between one month and 18 years old admitted to the pediatric neurology service were retrospectively analyzed. Diagnoses of neurological and infectious disease, antibiotics and antiepileptics used, and culture antibiogram results were recorded. Results: The most common infectious disease in children with neurological disease was lower respiratory tract infections (50%). Antibiotic use rate in children with neurological diseases was 51.9% (32.4% single and 19.4% combined). Lower respiratory tract infections (50%) were the leading antibiotic indications. Third generation cephalosporins (46%) were the most used in mono antibiotherapy, carbapenems (26.6%), gylicopeptides (26.6%) and broad-spectrum penicillins (10%) were used at higher rates in combined antibiotherapy. Pathogenic microorganisms such as Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa, Klebsiella pneumoniae, Morganella morganii and Enterococcus raffinosus were grown in urine cultures, Staphylococcus aureus and Enterococcus faecium in blood cultures. 59.3% of the children with neurological diseases were receiving antiepileptic treatment. Valproic acid 24.6%, levetiracetam 20.0%, phenobarbital and carbamazepine were used at 10.8% frequency. Conclusion: The most common infectious disease in hospitalized children with neurological disease is lower respiratory tract infections. Although cephalosporin is mostly preferred in mono-antibiotherapy, carbapenem and glycopeptides come to the fore in combined therapy. It is important to know the infections that may develop in the follow-up of this group of patients and the possible causative pathogens for rapid and effective treatment and to reduce health costs.Öğe Herpes Zoster in Children; Should the Varicella Vaccine be Administered as a Single Dose or a Double Dose?(Galenos Publ House, 2022) Celik, Taylan; Inan, Dogan BahadirIntroduction: In this study, we aimed to evaluate the clinical and epidemiological characteristics of children followed up with the diagnosis of herpes zoster, together with the data of our country. Materials and Methods: Patients who were followed up with the diagnosis of Herpes Zoster in the Pediatric Infectious Diseases Clinic of Kayseri Training and Research Hospital between 2016-18 were analysed retrospectively. Results: Twenty (69%) of 29 patients included in the study were female. The mean age of the patients, whose ages ranged from 2 to 16 years, was 8.86 +/- 0.6 years. Twenty (69%) of the patients had varicella infection and 6 (20.7%) had a history of single-dose varicella vaccination. The mean age of those who had varicella vaccine was 4.33 +/- 0.5, and those who had the varicella infection were 9.9 +/- 0.6 years. Four of the patients (13.8%) presented with only rash. Along with the rash, 25 patients (85.8%) had pruritus and 14 (48.3%) described pain. Thoracic dermatomes were most frequently involved with 69%, followed by cervical (17.3%), lumbar (10.3%) and trigeminal (3.4%) dermatomes, respectively. The patients had no known chronic disease, immunodeficiency (primary or secondary) or history of surgical intervention. Conclusion: This study, emphasizes that varicella vaccination can change the epidemiology of HZ in healthy children, causing it to be seen at an earlier age, and emphasizes the importance of two-dose vaccination.Öğe Perianal Abscess in Children: Are Resistant Microorganisms a Real Problem?(Aves Yayincilik, Ibrahim Kara, 2022) Celik, Taylan; Kaan, Emre; Caglar, OzgurObjective: Perianal abscess is a common purulent disease in daily pediatric practice caused by infection of perianal tissues and cavities. There is a strong male dominance in affected children less than two years old. In our study, we aimed to investigate the clinical and laboratory studies of cases diagnosed with perianal abscess in childhood. Material and Methods: Medical data followed by the diagnosis of perianal abscess by Kayseri Training and Research Hospital, Pediatric Infectious Diseases between October 2016, and June 2018, were retrospectively analyzed. Results: A total of 15 patients were followed up with a diagnosis of perianal abscess. Fourteen (93.3%) of the patients were male. Their average age was 19.10 +/- 8.86 months. Seven (46.6%) of the patients were less than six months old and 11 (73.3%) were younger than one year old. Fever was associated with only one (6.7%) correspondence complaints, 13 (86.6%) patients were brought close to perianal row swelling. Surgical drainage was applied to all 12 (80%) patients who were hospitalized and followed up. There was growth in the abscess culture in 10 (83.3%) of the patients. In 60% of the patients with culture growth, the agents were resistant microorganisms. In 50% of our hospitalized cases, treatment change was required according to the culture antibiogram results, and the combined use of meropenem and amikacin was preferred in these patients. Conclusion: In conclusion, although perianal abscesses are common in children, data on the management and treatment of the disease are limited. Our study highlights the benefit of routine abscess culture in the treatment of perianal abscesses.Öğe Retrospective Evaluation of Cases Accepted by Inter-hospital Transfer to the Pediatric Emergency Clinic(Galenos Publ House, 2022) Celik, Taylan; Guzel, Sinan; Canakkale, Fatih BattalIntroduction: Inter-hospital transport is an important process of pediatric emergency and pediatric intensive care; the patient is transferred to another center with the emergency medical services. Inter-hospital transport can be life-saving for pediatric patients, but the process can logistically be difficult and risky. The actions required to prevent unwanted events during transport depend mostly on the accurate and reliable data obtained. We think that research on the transport of pediatric patients is limited in our country. Our study investigated the characteristics of pediatric patients transferred to our unit by ambulance and the problems during transport.Methods: One hundred and eighty-three patients under the age of 18 who were referred to the pediatric emergency service between June 2017 and June 2019, whose data were regularly recorded, were included in our study. Data of patients who were sent to the external center for consultation via 112 were excluded. The list of the transferred patients was obtained from 112 command centers in our city and the patient records were analyzed retrospectively with the hospital information management system.Results: Fifty-nine percent of the 183 patients included in our study were male. The mean age of the patients was 62.2 +/- 39.1 months. Fourty-two percent of the patients were between 1 month and 3 years old. We found that the most frequent transports are in the spring with 42.6% and 50.9% of the transports took place between 16.00-00.00 hours. We found that the most common transported patients were pneumonia with 28.4% and respiratory distress was the most common adverse event during transport with 7.1%.Conclusion: In the transfer of pediatric patients between hospitals, every step, from the training of staff to the equipment in the ambulance, should be planned in detail. We believe that more studies are needed to examine transport protocols for children's emergency medical services, the level of education required by the transport team, the state of the medical device used in the transport process, the patient's pre and posttransport stability, and the safety of the patient during the transport period.
