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Öğe Burkholderia cepacia complex bacteremia outbreaks among non-cystic fibrosis patients in the pediatric unit of a university hospital(Turkish J Pediatrics, 2021) Tüfekci, Sinan; Şafak, Birol; Nalbantoğlu, Burçin; Samancı, Nedim; Kiraz, NuriBackground. Burkholderia cepacia complex (Bcc) comprises multi-drug resistant, Gram-negative, motile, and aerobic bacteria. Bcc causes severe nosocomial infections particularly in patients with intravascular catheters and in those with cystic fibrosis. We studied a Bcc outbreak in non-cystic fibrosis patients. Methods. We analyzed data from six patients hospitalized at our center. Blood cultures identified as infectious were incubated onto 5% blood sheep agar, chocolate agar, and eosin methylene blue (EMB) agar. We examined possible sites that could be sources of infection at the clinic. We confirmed isolations with pulsed-field gel electrophoresis (PFGE) tests. Results. The first patient was hospitalized due to left renal agenesis, urinary tract infection, and renal failure. Bcc was isolated in blood cultures obtained due to high fever on the third day of hospitalization. We stopped new patient hospitalizations after detecting Bcc in blood cultures of other five patients. We did not detect further positive specimens obtained from other clinic and the patient rooms. PFGE patterns were similar in all clinical isolates of Bcc indicating that the outbreak had originated from the source. Conclusions. Bcc infection should be considered in cases of nosocomial outbreaks of multi-drug resistant organisms that require hospitalization at intensive care units. Control measures should be taken for prevention of nosocomial infections and required investigations should be done to detect the source of infection.Öğe Determination of the normal anal location in neonates: A prospective cross-sectional study(Galenos, 2021) Tüfekci, Sinan; Yeşildağ, EbruAim: Anterior displacement of the anus might be a form of anorectal malformations. The study aims to measure the anal position index (API) in neonates with a modified method. Methods: The study was conducted between March 1, and December 31, 2019, in the neonatal unit at Tekirdag Namık Kemal University Hospital. The neonates between 35 and 42 gestational weeks and those without congenital malformation were included in the study. Four hundred five neonates were evaluated prospectively. API was determined by using distances between posterior fourchette-anus and posterior fourchette-coccyx in girls; scrotum-anus, and scrotum-coccyx in boys. Results: Of 405 participants, there were 230 males. API was found 0.52±0.05 and 0.39±0.04 in boys and girls, respectively. For the diagnosis of the anterior location of the anus, the lower limit was 0.33 cm in girls and 0.43 cm in boys. According to these results, nine boys (3.9%) and seven girls (4%) had an anteriorly located anus. Conclusion: API could be measured more accurately by the modified method and this resulted in a lower incidence of anterior location when compared with the previously defined techniques. © 2021 by The Medical Bulletin of İstanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayınevi.Öğe Evaluation of immunogenicity after first dose of hepatitis B vaccine in newborns with very low birth weight(Taylor and Francis Ltd., 2021) Tüfekci, Sinan; Aygün, Erhan; Halis, HülyaObjective: Hepatitis-B virus (HBV) infection is an important health problem worldwide. HBV vaccine application varies according to the birth weight and gestational week in the neonatal period. This study aimed to reconsider delaying the administration of the HBV vaccine because the birth weight of newborns was very low. Methods: The newborns with very low birth weight in the study group were babies weighing less than 2000 g in the postnatal first month and at the time of administering HBV vaccine. Babies born at term from mothers who did not receive an HBV vaccine, had negative hepatitis B surface antibody levels, and were given HBV vaccine at birth were included in the study as a control group. The antibody levels against HBV vaccine were compared between these two groups. Results: The retrospective study included 60 participants (32 men and 28 women) grouped as control first vaccine weight (first vaccine weight was >2000 g, control group, n = 30) and case vaccine weight (first vaccine weight was <2000 g, case group, n = 30). The mean birth weight was 2976 ± 84.8 g and 1054 ± 44.5 g in the control and case groups, respectively. The first vaccine weight was 2030–3780 g and 960–1900 g in the control and case groups, respectively. The mean antibody level was 297.8 ± 76.3IU/mL and 309.7 ± 56.3IU/mL in the <1500 g and >1500 g groups, respectively. No significant difference was found in hepatitis antibody levels between the groups. Conclusion: Further studies in larger samples are needed to confirm the efficacy and efficiency of postponement of hepatitis B vaccination in babies with a birth weight of <2000 g. © 2021 Taylor & Francis Group, LLC.Öğe Evaluation of Two Consecutive High Sensitivity Cardiac Troponin T Measurements in Healthy Newborns and Newborns with Respiratory Failure(2021) Tüfekci, Sinan; Kızılca, Özgür; Çelikkol, Aliye; Topçu, BirolObjective: Data on the umbilical cord and postnatal physiological limits of the high sensitivity cardiac troponin T (hs cTnT) in newborns are scarce. This study aims to determine the normal values and upper limits of hs cTnT in healthy newborns. In addition, its clinical significance and usability in neonatal respiratory failure were analyzed. Method: In this non-invasive and retrospective, cross-sectional study, 113 healthy newborns and 93 newborns with non-cardiac respiratory failure, born between July 2018 and January 2020, were evaluated. Hs cTnT was measured in the umbilical cord and 24-96 h after birth in infants. Results: In the healthy group, the median umbilical cord hs cTnT was 38 (17-156) ng/L and 99th percentile hs cTnT was 122 ng/L, and in the respiratory failure group, the median umbilical cord hs cTnT was 72 (27- 326) ng/L. Postnatal day 2-4 median hs cTnT was 75 (10-194) ng/L and 99th percentile value was 194 ng/L in the healthy group, and the median hs cTnT was 145 (41-409) ng/L in the respiratory failure group. The calculated area under the ROC curve for umbilical cord hs cTnT was 0.848 [cut-off: 64, 95% confidence interval (CI): 0.79-0.90, sensitivity: 62.4%, specificity: 93.7%], suggesting that umbilical cord hs cTnT is a sensitive marker for the prediction of neonatal respiratory failure. The calculated area under the ROC curve for control hs cTnT was 0.851 (cut-off: 121.5, 95% CI: 0.79- 0.90, sensitivity: 71%, specificity: 86.8%), suggesting that control hs cTnT is a sensitive marker for the prediction of neonatal respiratory failure. Conclusion: The results show that the reference range of umbilical cord and postnatal hs cTnT in healthy newborns is higher than that in adults. Both hs cTnT values were higher in the neonatal respiratory failure group than those in the healthy group.Öğe Most proper timing of transcutaneous bilirubin measurement after phototherapy treatment in the newborn period(Kowsar Medical Institute, 2021) Tüfekci, Sinan; Aygün, ErhanBackground: There are limited data about the proper transcutaneous bilirubin measuring time to detect levels that are close to serum bilirubin levels after ending the phototherapy treatment. Objectives: To compare the transcutaneous bilirubin and total serum bilirubin levels, and to evaluate the reliability of transcuta-neous bilirubin measurements after phototherapy treatment of newborns because of hyperbilirubinemia. Methods: The study included 105 late preterm and term newborns consisting of 56 females (53.3%) and 49 males (46.6%), with gesta-tional age 350/7-416/7 weeks who were treated with phototherapy. A Bilicheck (M&B-MBJ20) device was used for transcutaneous biliru-bin measurements. The average of three measurements on the skin in the mid-sternal area were obtained. Correlations between transcutaneous bilirubin and venous bilirubin levels were evaluated 6 and 12 hours after phototherapy. Transcutaneous bilirubin measurements were performed simultaneously with blood collection or within a maximum ± 15 minutes time difference for total serum bilirubin. Results: The average phototherapy time was 10 ± 2 (range, 8-12) hours. The average difference between transcutaneous bilirubin and venous bilirubin levels post phototherapy was 2.61 mg/dL after 6 hours and 0.8 mg/dL after 12 hours. The hematocrit levels of the patients ranged between 40-66% with an average of 53% ± 4.8, the median level was 51%. Correlation coefficients according to hours after treatment were high for the 6th hour (r = 0.76) and very high for the 12th hour. Conclusions: Jaundice scanning with transcutaneous bilirubin measurements 6-12 hours after the end of phototherapy is reliable and may be helpful in preventing additional blood collection from the heel. © 2021, Author(s).Öğe The School Milk Project Conducted in Primary Schools and Parents' Point of Views on the Issue(2019) Tüfekci, Sinan; Sertel Tüfekçi, Bilge; Topçu, BirolAim:In this study, our objective was to find out the opinion of the parents, whose children participated in the school milk project program (SMP), and to determine the acceptability of this program in the society.Materials and Methods:Ultra-heat treated (UHT) milk (200ml) was distributed to 6,5 million students in the second half of the 2013-2014 school year by the ministry. This study was conducted to find out the opinion of the families of children, who participated in the SMP in Malkara / Tekirdağ. For this purpose, a questionnaire containing 13 questions wasused.Results:The educational status of parents were as follows: 1.47% illiterate; 35.8% primary school graduates; 12.9% secondary school graduates; 28.7% high school graduates and 20.79% university graduates. A total of 73.16% of children have breakfast on a regular basis. Regarding the weekly milk consumption of children; 6.38% did not drink milk at all; 37.32% 1-3 days, 19.64% 4-6 days and 36.6% used to consume milk every day. 91.49% of parents were informed about SMP and 99.51% stated that they filled a permission form. 83.63% of parents believed that SMP was necessary and 16.37% believed that it was not necessary. 98.36% of parents gave a positive answer and 1.64% gave a negative answer to the question about the contribution of SMP to the growth of children. 66.78% of the participating parents believed and 33.22% did not believe that milk is protective against diseasesinolderages.Conclusion:The School Milk Project gained families’ acceptance and contributes to the healthy and balanced nutrition of children from the low-income segment.
