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Öğe Epidemiologic and microbiologic evaluation of catheter-line bloodstream infection in a pediatric hematopoietic stem cell transplant center(Mosby-Elsevier, 2024) Aksoy, Basak A.; Kara, Manolya; Sutcu, Murat; Ozbek, Ahmet; Ersoy, Gizem Z.; Oner, Ozlem B.; Aydogdu, SelimeBackground: Children who underwent hematopoietic stem cell transplant (HSCT) transplants are at high risk of developing central-line-associated bloodstream infections (CLABSIs). The present study aimed to identify possible risk factors for mortality by analyzing the clinical and laboratory characteristics of patients diagnosed with CLABSI in our pediatric hematopoietic stem cell transplant unit.Methods: The initial CLABSI episodes of 102 children were analyzed. Medical records of the patients were evaluated by preformed standardized surveys. Univariate analysis and multivariate logistic regression analysis were performed to identify risk factors for mortality.Results: Thirty-five patients (34.3%) were female. The median age was 48 months (3-204). The median time to onset of CLABSI was 19 days (4-150). The gram-negative and gram-positive bacteria ratio among the causative agents was 57.8% to 34.3%. The mortality rate was 12.6%. The presence of severe neutropenia, initiation of inappropriate empirical antibiotic therapy, the presence of hypotension, persistent bacteremia, pediatric intensive care unit admission, growth of carbapenemase-positive gram-negative microorganism and multidrug-resistant bacteria were significantly high in the mortality group when compared to survivors. The presence of hypotension, inappropriate empirical antibiotic therapy, and persistent bacteremia were found to be independent risk factors for mortality.Conclusions: Rational use of antibiotics, active surveillance and screening of patients together with improved infection control practices may reduce the incidence and the consequences of CLABSIs.(c) 2023 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.Öğe THE IMPACT OF TREOSULFAN -BASED CONDITIONING FOR PRIMARY IMMUNE DEFICIENCIES: SINGLE CENTER EXPERIENCE(Springernature, 2023) Ersoy, Gizem Zengin; Cipe, Funda; Alsoy, Basak Adakli; Hashemi, Nazli; Oner, Ozlem Basoglu; Aydogdu, Selime; Dikme, Gurcan[Abstract Not Available]Öğe The impact of Treosulfan-based conditioning for inborn errors of immunity: Is dose monitoring crucial?(Wiley, 2023) Ersoy, Gizem Zengin; Cipe, Funda; Fisgin, Tunc; Aksoy, Basak Adakli; Oner, Ozlem Basoglu; Hashemi, Nazli; Aydogdu, SelimeIntroductionIn children with inborn errors of immunity (IEI) who will receive a hematopoietic stem cell transplant (HSCT) treosulfan-based conditioning is currently preferred. The aim of this study was to investigate early and late outcomes in pediatric IEI patients receiving pre-HSCT treosulfan and to examine the effect of treosulfan dose monitoring on outcomes. MethodsSeventy-three pediatric patients receiving this management between 2015 and 2022 were included. ResultsOverall survival rate was 80%, and event-free survival was 67.8%. A larger treosulfan dose AUC after first application increased the rate of early toxicity (p = .034) and slowed lymphocyte engraftment (r = .290; p = .030). Underlying disease, treosulfan AUC, donor type, stem cell type, number of immunosuppressive agents, the dose of anti-thymocyte globulin, and post-transplantation cyclophosphamide did not to increase risk of acute graft-versus-host disease. The risk of mixed chimerism (MC) in patients with autoimmune lymphoproliferative syndrome and leukocyte adhesion deficiency were higher than those with severe combined immunodeficiency (p = .021 and p = .014, respectively). The risk of MC was lower in those receiving peripheral blood stem cells (SC) compared with bone marrow derived SC (OR = .204, p = .022). ConclusionThe AUC of the treosulfan dose was not associated with poorer late outcomes. Treosulfan is an agent that can be used safely in the IEI patient group, level measurement appears essential to identify early toxicities. Prospective studies with more extended follow-up periods are needed.Öğe WOULD MONITORIZING TREOSULFAN LEVELS IN PATIENTS TRANSPLANTED FOR TRANSFUSION DEPENDENT THALASSEMIA BE BENEFICIAL IN TERMS OF CHIMERIZM? A SINGLE CENTER EXPERIENCE(Springernature, 2023) Aksoy, Basak Adakli; Ersoy, Gizem Zengin; Elsayed, Mariam; Oner, Ozlem Basoglu; Aydogdu, Selime; Dikme, Gurcan; Erdem, Melek[Abstract Not Available]
