Browsing by Author "Ozen, Metehan"

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Comparison of pediatric and adult antibiotic-associated diarrhea and Clostridium difficile infections
(BAISHIDENG PUBLISHING GROUP INC, 2016-01-01) McFarland, Lynne Vernice; Ozen, Metehan; Dinleyici, Ener Cagri; Goh, Shan
Antibiotic-associated diarrhea (AAD) and Clostridum difficile infections (CDI) have been well studied for adult cases, but not as well in the pediatric population. Whether the disease process or response to treatments differs between pediatric and adult patients is an important clinical concern when following global guidelines based largely on adult patients. A systematic review of the literature using databases PubMed (June 3, 1978-2015) was conducted to compare AAD and CDI in pediatric and adult populations and determine significant differences and similarities that might impact clinical decisions. In general, pediatric AAD and CDI have a more rapid onset of symptoms, a shorter duration of disease and fewer CDI complications (required surgeries and extended hospitalizations) than in adults. Children experience more community-associated CDI and are associated with smaller outbreaks than adult cases of CDI. The ribotype NAP1/027/BI is more common in adults than children. Children and adults share some similar risk factors, but adults have more complex risk factor profiles associated with more co-morbidities, types of disruptive factors and a wider range of exposures to C. difficile in the healthcare environment. The treatment of pediatric and adult AAD is similar (discontinuing or switching the inciting antibiotic), but other treatment strategies for AAD have not been established. Pediatric CDI responds better to metronidazole, while adult CDI responds better to vancomycin. Recurrent CDI is not commonly reported for children. Prevention for both pediatric and adult AAD and CDI relies upon integrated infection control programs, antibiotic stewardship and may include the use of adjunctive probiotics. Clinical presentation of pediatric AAD and CDI are different than adult AAD and CDI symptoms. These differences should be taken into account when rating severity of disease and prescribing antibiotics.
Gut immune homeostasis: the immunomodulatory role of Bacillus clausii, from basic to clinical evidence
(TAYLOR \& FRANCIS LTD, 2022-01-01) Wong-Chew, Rosa Maria; de Castro, Jo-Anne A.; Morelli, Lorenzo; Perez, Marcos; Ozen, Metehan
Introduction The gut microbiota affects the development of the gut immune system in early life. Perturbations to microbiota structure and composition during this period can have long-term consequences on the health of the individual, through its effects on the immune system. Research in the last few decades has shown that probiotic administration can reverse these effects in strain- and environment-specific ways. Bacillus clausii (B. clausii) has been in use for many decades as a safe and efficacious probiotic, but its mode of action has not yet been completely elucidated. Areas covered In this review, we discuss how the gut immune system works, the factors that affect its functioning, and the plethora of research highlighting its role in various diseases. We also discuss the known modes of action of Bacillus probiotics, and highlight the preclinical and clinical evidence that reveal how B. clausii acts to bolster gut defense. Expert opinion We anticipate that the treatment and/or prevention of dysbiosis will be central to managing human health and disease in the future. Discovering the pathophysiology of autoimmune diseases, infections, allergies, and some cancers will aid our understanding of the key role played by microbial communities in these diseases.
Mediastinal vacuum-assisted closure therapy following pediatric congenital cardiac surgery
(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2017-01-01) Aydin, Selim; Temur, Bahar; Suzan, Dilek; Kirat, Baris; Demir, Ibrahim Halil; Ozen, Metehan; Erek, Ersin
Background: In this study, we report nine pediatric cases who developed sternal wound complications following complex congenital cardiac surgery and treated with mediastinal vacuum-assisted closure technique. Methods: Between January 2014 and December 2015, a total of 473 congenital heart operations were performed in our hospital. Of these patients, nine (8 males, 1 females
Mini Epidemic of Acinetobacter Junii in a Neonatal Intensive Care Unit: Risk Factors and Control Procedures
(GALENOS YAYINCILIK, 2015-01-01) Sandal, Gonca; Cetin, Hasan; Ozen, Metehan; Aynali, Ayse
Aim: Acinetobacter spp. have emerged as important nosocomial pathogens in recent decades because of the increase in the incidence of antibiotic-resistant strains. Acinetobacter junii accounts for less than 1\% of isolates. Acinetobacter junii is a gram-negative, non-fermentative cocobacillus that might cause bacteremia, especially in immunocompromised patients and newborns. This article described a mini epidemic of Acinetobacter junii that has been experienced in a neonatal intensive care unit (NICU), and taken measures to control it. Materials and Methods: The outbreak occurred at Suleyman Demirel University Hospital, Pediatrics Department, Neonatal Intensive Care Unit in August 2013. The 15-bed at NICU provides care for level 3 patients. Clinical signs of sepsis were observed in 8 of 15 infants who were treated in the neonatal intensive care unit. Results: Acinetobacter junii were isolated in six infants. Isolates were from blood cultures of five patients and one was from the blood and the cerebrospinal fluid cultures of the same patient. Two preterm and five late preterm babies were affected from epidemic. A 25 week old preterm baby died because of septic shock at the fifth hour of his treatment. Conclusion: The present study confirms that Acinetobacter junii is an important nosocomial pathogen in neonatal period. As a part of rigid infection control, intravenous feedings should be prepared under aseptic conditions.
Pediatric Neutropenic Patients Care in Turkey
(AVES YAYINCILIK, IBRAHIM KARA, 2019-01-01) Aydin, Zeynep Gokce Gayretli; Buyukcam, Ayse; Kara, Ates; Karbuz, Adem; Soysal, Ahmet; Tapisiz, Anil Aktas; Parlakay, Aslinur Ozkaya; Somer, Ayper; Caliskan, Ayse Bahar Budan; Kocabas, Bilge Aldemir; Okur, Dicle Sener; Ciftdogan, Dilek Yilmaz; Arisoy, Emin Sami; Kocabas, Emine; Ciftci, Ergin; Erduran, Erol; Vardar, Fadil; Tanir, Gonul; Sensoy, S. Gulnar; Bayhan, Gulsum Iclal; Devrim, Ilker; Celik, Melda; Ozen, Metehan; Kosker, Muhammet; Erguven, Muferret; Dalgic, Nazan; Hatipoglu, Nevin; Oz, Fatma Nur; Belet, Nursen; Akcan, Ozge Metin; Ceylan, Ozgur; Siraneci, Rengin; Bozdemir, Sefika Elmas; Ozkasap, Serdar; Celebi, Solmaz; Celik, Umit; Camcioglu, Yildiz; Kara, Aybuke Akaslan; Kupeli, Begul; Gulhan, Belgin; Albayrak, Eda; Erdeniz, Emine Hafize; Yasa, Emine Olcay; Turkkan, Emine; Tezer, Hasan; Sutcu, Murat; Bayram, Nuri; Hatipoglu, Sami; Oncel, Selim; Celik, Taylan; Torun, Yasemin Altuner; Koksal, Yavuz; Cay, Ummuhan; Kara, Ahu; Yoruk, Mustafa Asim; Demirdag, Tugba Bedir
Objective: Infection is a common complication in children with malignancies. There is no consistent guidance for environmental infection control and isolation precautions for neutropenic patients (NP). There are differences between centers. The aim of this questionnaire study was to determine these differences in Turkey. Material and Methods: A multicenter-descriptive questionnaire was conducted on 36 centers from different geografical locations of Turkey. Bone marrow transplantation units were excluded. Each center was contacted at least three-times. Questionnaire was answered by two different doctors from each center. Results: Thirty-six centers including 20 (55.5\%) University Hospitals, 12 (\%33.3) Research Hospitals, three (8.3\%) State Hospital and one Private University Hospital participated in this survey. 94.3\% of the centers had a bed capacity of 50 beds and over. Twenty-one (58.3\%) centers had pediatric infection ward that followed febrile NP. All centers had an infection control committee. 25\% (9/36) of the centers always followed pediatric neutropenic fever patients in a single room. 66.6\% (24/36) of the centers had toilet in all patients' room. The door features of patients' room included mostly (94.1\%, 32/34) manually opened door. Ten (27.7\%) centers had hepa filter system, five of them had positive-negative pressure room. Thirteen (38.2\%, 13/34) centers prefered hickmann catheter for accessing a patient's central line. Training was given for catheteter care in all centers. Sixteen (44.4\%) centers had determined policies about keeping toys in patient rooms. Visitor restrictions were performed in all centers. None of the centers allowed plants or flowers in hospital rooms. There was a neutropenic diet specific for pediatric NP provided in twenty-seven centers (75\%). Conclusion: The prevention and control of infection contributes to the improvement of the prognosis of patients with hematological malignancies. Physicians must be aware of the infection risks and take precautions for infectious complications through the neutropenic period and standard protocols should be established and implemented for patients with hematological malignancies.
Probiotics added to maternal nutrition affect infantile colic symptoms and fecal microbiota profile: a single-blind randomized controlled study
(Korean Pediatric Soc, 2022-01-01) Karaahmet, Aysu Yildiz; Dolgun, Gulumser; Ozen, Metehan
Background: Infantile colic has a multifactorial etiology
Time Series Analysis of the Microbiota of Children Suffering From Acute Infectious Diarrhea and Their Recovery After Treatment
(FRONTIERS MEDIA SA, 2018-01-01) Dinleyici, Ener C.; Martinez-Martinez, Daniel; Kara, Ates; Karbuz, Adem; Dalgic, Nazan; Metin, Ozge; Yazar, Ahmet S.; Guven, Sirin; Kurugol, Zafer; Turel, Ozden; Kucukkoc, Mehmet; Yasa, Olcay; Eren, Makbule; Ozen, Metehan; Manuel Marti, Jose; Garay, Carlos P.; Vandenplas, Yvan; Moya, Andres
Gut microbiota is closely related to acute infectious diarrhea, one of the leading causes of mortality and morbidity in children worldwide. Understanding the dynamics of the recovery from this disease is of clinical interest. This work aims to correlate the dynamics of gut microbiota with the evolution of children who were suffering from acute infectious diarrhea caused by a rotavirus, and their recovery after the administration of a probiotic, Saccharomyces boulardii CNCM I-745. The experiment involved 10 children with acute infectious diarrhea caused by a rotavirus, and six healthy children, all aged between 3 and 4 years. The children who suffered the rotavirus infection received S. boulardii CNCM I-745 twice daily for the first 5 days of the experiment. Fecal samples were collected from each participant at 0, 3, 5, 10, and 30 days after probiotic administration. Microbial composition was characterized by 16S rRNA gene sequencing. Alpha and beta diversity were calculated, along with dynamical analysis based on Taylor's law to assess the temporal stability of the microbiota. All children infected with the rotavirus stopped having diarrhea at day 3 after the intervention. We observed low alpha diversities in the first 5 days (p-value <0.05, Wilcoxon test), larger at 10 and 30 days after probiotic treatment. Canonical correspondence analysis (CCA) showed differences in the gut microbiota of healthy children and of those who suffered from acute diarrhea in the first days (p-value <0.05, ADONIS test), but not in the last days of the experiment. Temporal variability was larger in children infected with the rotavirus than in healthy ones. In particular, Gammaproteobacteria class was found to be abundant in children with acute diarrhea. We identified the microbiota transition from a diseased state to a healthy one with time, whose characterization may lead to relevant clinical data. This work highlights the importance of using time series for the study of dysbiosis related to diarrhea.