Ergin Ciftçi

Akdeniz University, Satalia, Antalya, Turkey

Are you Ergin Ciftçi?

Claim your profile

Publications (89)129.54 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Acute gastroenteritis is an important cause of morbidity and mortality in developing countries. Children under 5 years of age are more commonly affected, while 80% of deaths occur in children under 2 years of age. Escherichia coli, Salmonella spp., and Shigella spp. are the most common causative bacterial pathogens. Since the summer of 2014, a large number of Salmonella and Shigella gastroenteritis cases have occurred in our region, which is considered as a small local outbreak. We aim to report the features and antibiotic susceptibility of microorganism isolates obtained during this epidemic. Material and Methods: Between July and September 2014, patients who were admitted to pediatric clinics and emergency services on account of acute gastroenteritis lasted less than 15 days were included in this retrospective study. Stool microscopy, stool cultures, and blood cultures were performed. Salmonella and Shigella strains were subjected to antimicrobial susceptibility testing. Results: A total of 2425 patients were admitted because of acute gastroenteritis during the study period. Salmonella spp. and Shigella spp. were isolated in 113 children. The mean age of the children was 91.5±60.3 months (4-213 months). Of the 113 patients, 56% were male and 44% were female. Shigella spp. were found in 77 patients (3.2%), and Salmonella spp. were found in 36 patients (1.5%). Salmonella enteritidis was detected in 29 patients (80.5%), whereas Salmonella typhimurium was detected in 3 patients (8.3%). In addition, Shigella sonnei was identified in 63 patients (81.8%) and Shigella flexneri in 8 patients (10.3%). In contrast to ceftriaxone susceptibility in Salmonella strains, 9.1% of Shigella strains were found to be resistant to ceftriaxone. Ciprofloxacin resistancewas found in 5.6% and 1.3% strains of Salmonella and Shigella spp. respectively. Although the ampicillin resistance values of 2 strains were close, trimethoprim-sulfamethoxazole (TMP) resistance was found in 89.6% Shigella strains. Conclusion: Salmonella and Shigella are common bacterial pathogens. Resistance patterns must be known to select the most effective treatment. According to our study, ceftriaxone and ciprofloxacin appear to be the first choice of empirical treatment for acute bacterial gastroenteritis. Additionally, if the resistance states of ampicillin and TMP are known, these drugs can also be used as empirical treatment.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Rotavirus may cause life-threatening complications in untreated patients during the course of gastroenteritis. Electrolyte imbalance, bacteremia and sepsis are the most common complications of rotavirus gastroenteritis (RG). It is believed that translocation of intestinal microorganisms as a result of intestinal epithelium dysfunction is the underlying mechanism of bacteremia in RG. Although Gram-negative bacteremia has been noted as a complication in RG, Staphylococcus aureus bacteremia and endocarditis have not been reported previously. A 22-month-old boy was admitted with complaints of fever, diarrhea and dehydration. He was diagnosed with RG complicated with S. aureus bacteremia, pyomyositis and endocarditis. We call attention to these complications in patients with prolonged or late-onset fever during RG as rare complications of the disease. © 2015 Japan Pediatric Society.
    Pediatrics International 08/2015; 57(4):780-782. DOI:10.1111/ped.12649 · 0.73 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Aims: To evaluate the effectiveness of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach in Turkey and analyse predictors of poor hand hygiene compliance. Design: An observational, prospective, interventional, before-and-after study was conducted from August 2003 to August 2011 in 12 intensive care units (ICU) of 12 hospitals in 11 cities. The study was divided into a baseline and a follow-up period and included random 30-minute observations for hand hygiene compliance in ICU. The hand hygiene approach included administrative support, supplies availability, education and training, reminders in the workplace, process surveillance, and performance feedback. Results: We observed 21,145 opportunities for hand hygiene. Overall hand hygiene compliance increased from 28.8% to 91% (95% CI 87.6–93.0, p 0.0001). Multivariate and univariate analyses showed that several variables were significantly associated with poor hand hygiene compliance: males vs. females (39% vs. 48%; 95% CI 0.79–0.84, p 0.0001), ancillary staff vs. physicians (35% vs. 46%, 95% CI 0.73–0.78, p 0.0001), and adult vs. pediatric ICUs (42% vs. 74%, 95% CI 0.54–0.60, p 0.0001). Conclusions: Adherence to hand hygiene was significantly increased with the INICC Hand Hygiene Approach. Specific programmes should be directed to improve hand hygiene in variables found to be predictors of poor hand hygiene compliance.
    Journal of Infection Prevention 07/2015; 16(4):146-154. DOI:10.1177/1757177414560249
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Varicella in previously immunized individuals, known as "breakthrough varicella". While the majority of breakthrough cases are mild, some may be severe, requiring hospitalization in previously healthy children or children with an underlying condition. This report, as a part of the prospective national pediatric varicella hospitalizations study (including 29 centers, represent 50% of pediatric population) in Turkey, is aimed to evaluate breakthrough varicella infection requiring hospitalization before the routine use of single-dose live varicella vaccine in national program from 2008 to 2013 (<10% of the pediatric age group received a single-dose vaccine). In the time period, 1939 children were hospitalized due to varicella infection in Turkey; 36 children (20 boys, 16 girls, mean age 68.0+37.6 months, all received single dose live varicella vaccine) with breakthrough varicella infection. Breakthrough varicella infection might be severe in previously healthy children (61.1%) and children with immune-compromising conditions (38.9%). The time elapsed between vaccination and hospitalization was approximately 5 years, and neurological complications, mainly encephalitis and meningitis, were the most common reason for hospitalization in previously healthy children. Pediatric breakthrough varicella requiring hospitalization have been seen in Turkey, is mainly observed in previously healthy children at 5 years after a single-dose varicella vaccine. The varicella vaccine has been implemented as part of the National Immunization Program in Turkey in 2013 (a single dose at age 12 months). Further surveillance in the same settings could evaluate the effectiveness of national immunization with single-dose varicella vaccine at 12 months of age and potential need for second dose of vaccine. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Vaccine 06/2015; 33(32). DOI:10.1016/j.vaccine.2015.06.029 · 3.62 Impact Factor

  • Clinical Pediatrics 05/2015; 54(9). DOI:10.1177/0009922815584930 · 1.15 Impact Factor

  • 04/2015; 9(1):1-11. DOI:10.5152/ced.2015.1516
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Orbital infections require prompt diagnosis and treatment because of the risk of severe complications. Although preseptal cellulitis and orbital cellulitis are different clinical conditions, they can often be confused or can be seen concomitantly. In this study, we aimed to evaluate all patients diagnosed with these diseases treated in our clinic in order to analyze clinical findings, preferred imaging modalities, treatment choices, and clinical outcomes. Material and Methods: This retrospective study was performed between January 1999 and January 2013. We evaluated patients who were admitted to the Ankara University Pediatric Infectious Disease Clinic with a diagnosis of preseptal or orbital cellulitis. Clinical and laboratory characteristics of the patients were compared. Significance level was determined as α=0.05. Results: A total of 71 patients (34 girls, 37 boys) with a diagnosis of preseptal (50 patients) or orbital cellulitis (21 patients) were included into the study. The mean age at diagnosis was 49±37.4 (2-168) months. Waters graphy and/or orbital computed tomography was performed in 27 (54%) patients with preseptal cellulitis and in 18 (85%) patients with orbital cellulitis. Almost all of the patients responded to medical therapy without sequelae, and only 3 of them required surgical treatment additionally. The patients with preseptal and orbital cellulitis were treated successfully with sulbactam-ampicillin (150 mg/kg/day and 200 mg/kg/day, respectively). Conclusion: We conclude that these infections can be treated without any morbidity and mortality if it is diagnosed early and suitable antibiotic treatment is promptly instituted. Imaging tools can give us detailed information regarding disease involvement, differential diagnosis, and the need for surgical intervention. However, we think that these imaging modalities, such as computed tomography, should be restricted as much as possible because of high-dose radiation exposure risk.
    02/2015; 8(4):148-152. DOI:10.5152/ced.2014.1815
  • Source
    Halil Ozdemir · Ergin Ciftci ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Invasive meningococcal disease is a serious and global life-threatening disease. It affects more than 500.000 people worldwide annually, with 50.000 deaths and 50.000-100.000 severe sequelae, despite treatment. Six serogroups (A, B, C, W135, X, and Y) account for the majority of cases of meningococcal disease worldwide. Meningococcal polysaccharide vaccines were introduced several decades ago and have led to the decline in the burden of disease. However, these vaccines have several limitations, including poor immunogenicity in infants and toddlers, short-lived protection, lack of immunologic memory and herd immunity, and negligible impact on nasopharyngeal carriage. The conjugation of polysaccharide vaccines has the potential to overcome these drawbacks. Herein, we reviewed the new information about the quadrivalent conjugated meningococcal vaccines and meningococcal serogroup B vaccines.
    02/2015; 8(4):178-186. DOI:10.5152/ced.2014.1765
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Kawasaki disease (KD) is a multisystemic vasculitic disease. Recurrent KD is rare and generally presents in a similar clinical picture as the first episode, and early diagnosis with prompt treatment is the key point in preventing associated cardiovascular morbidities.A 9-year-old boy, who was diagnosed with KD when he was 1.5 years' old, was referred to our hospital for surgical drainage of retropharyngeal abscess. He had a 7-day history of high fever, sore throat, left-sided neck swelling, and restricted neck movements. Subsequently, he was diagnosed with recurrent KD and retropharyngeal involvement. He was successfully treated with a single dose of intravenous immunoglobulin (IVIG) and acetyl salicylic acid.Recurrence is rare and occurs most commonly in children. Atypical presentation, incomplete disease, short duration of fever, and reduced response to IVIG treatment were found to be the risk factors for recurrence. KD can occasionally present with clinical and radiographic findings of deep neck bacterial infection. Unusual presentations in KD may cause delay in diagnosis and increase the risk of life-threatening complications.We describe a case of recurrent KD presenting with a clinical picture resembling retropharyngeal infection who fully recovered after 1 dose of IVIG instead of surgical drainage and antibiotic use.
    Medicine 12/2014; 93(29):e139. DOI:10.1097/MD.0000000000000139 · 5.72 Impact Factor

  • Pediatric Annals 11/2014; 43(11):442-3. DOI:10.3928/00904481-20141022-06 · 0.61 Impact Factor
  • Source

    07/2014; 8(2):86-88. DOI:10.5152/ced.2013.45
  • [Show abstract] [Hide abstract]
    ABSTRACT: We aimed both to define the characteristics of patients with Kawasaki Disease (KD), and to highlight infrequent and unusual findings of the disease by presenting selected cases. We retrospectively evaluated 35 patients diagnosed with KD in our clinic between January 1994 and January 2013. The male to female ratio was 1.33 and the median age at admission was 22 months (1.5-132 months). Fourteen patients (40%) had coronary artery lesions (CAL). Twenty-five cases (72%) had complete and 10 cases (28%) had incomplete KD; the incidence of CAL in these groups was 36% and 50%, respectively. Two patients had giant coronary aneurysms. Six cases received a second dose of intravenous immunoglobulin, and one patient received pulse methylprednisolone. Seven cases had unusual and/or infrequent presentation patterns and/or follow-up. Physicians should be aware of all symptoms and laboratory findings of KD in order to avoid any delays in diagnosis and decrease the risk of life-threatening complications.
    The Turkish journal of pediatrics 07/2014; 56(4):392-8. · 0.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 2.5-month-old boy admitted to our hospital with irritability, poor feeding and fever of 12 hours duration. On physical examination, he was febrile and extremely irritable. Initial whole blood count revealed a hemoglobin level of 10.1 g/dl, white blood count of 17,800/mm3 and platelet count of 454,000/mm3. Erythrocyte sedimentation rate was 80 mm/h and C-reactive protein was 3.96 mg/dl. Biochemical examinations of serum, urinalysis, chest X-ray, and analysis of cerebrospinal fluid (CSF) were normal. He was started on intravenous ampicillin and ceftriaxone empirically for provisional occult bacteremia. His blood, urine and CSF cultures were negative. On the 7th day of the treatment, there were no additional symptoms or findings other than fever. Echocardiography revealed aneurysms in both the left and right coronary arteries. Intravenous immunoglobulin (IVIG) and per oral aspirin were administered, and the fever resolved after IVIG infusion. Two years later, the echocardiography showed disappearing of the saccular aneurysm on the right coronary artery, but the dilatation of the left coronary artery was persisting. In conclusion, incomplete Kawasaki disease should always be included in the differential diagnosis of an infant with persistent fever, especially one younger than three months of age, when the conventional work-up fails to reveal the underlying cause.
    The Turkish journal of pediatrics 01/2014; 55(5):529-32. · 0.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Colistin is active against most multidrug-resistant, aerobic Gram-negative bacteria. Because of the reported nephrotoxicity during the first years of use of colistin, there were concerns of its use in pediatrics where there was limited experience The aim of this study is to document the clinical characteristics and outcomes of use of colistin in pediatric patients at a pediatric intensive care unit in Turkey. We reviewed the medical and laboratory records of 29 critically ill children who were treated with colistin for 38 courses between January 2011 and December 2011 at the Department of Pediatric Intensive Care Unit in Ankara University Medical School, Turkey. The median age was 17 months (range 3-217 months). Male-to-female ratio was 1:1.37. Ventilator-associated pneumonia (21 courses) was the leading diagnosis followed by catheter-related blood stream infection (6 courses), bacteremia (4 courses), ventriculoperitoneal shunt infection, peritonitis and pneumonia (1 course). The most commonly isolated microorganisms were Acinetobacter baumanni, Pseudomonas aeruginosa, Klebsiella pneumoniae, Serratia marcescens, Stenotrophomonas maltophilia, and Enterobacter cloacae. Two colistin formulations were used. Colimycin (Kocak Farma) was used in 21 colistin treatment episodes. The median dosage of colistin in this group was 5.0 mg/kg/d (2.3-5.6 mg/kg/d). Colomycin (Forest Laboratories) was used in 17 colistin treatment episodes. The median dosage of colistin in the second group was 75,000 International Unit/kg/d (50,000-80,000 International Unit/kg/d). Thirty colistin treatment episodes (79%) had a good or partial clinical response and 8 (21%) had a poor clinical response. Of the 8 colistin treatment episodes with poor clinical response, 3 were in the Colimycin group and 5 were in the Colomycin group. Ten patients died. There was no evidence of neurotoxicity in this study. Nephrotoxicity was observed in 1 patient but was not attributed to colistin because the patient had multiorgan failure at the same time. This study in a small cohort of patients suggests that the use of colistin in severe nosocomial infections caused by multidrug-resistant Gram-negative bacteria is well-tolerated and efficacious.
    The Pediatric Infectious Disease Journal 01/2014; 33(1):e19-e24. DOI:10.1097/INF.0000000000000117 · 2.72 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Previous studies in adults and case reports in children have shown increased frequency of hypothalamo-pituitary dysfunction after infectious diseases of the central nervous system. The aim of this study was to evaluate the function of hypothalamo-pituitary axis in children with a history of bacterial meningitis. Patients diagnosed with bacterial meningitis between April 2000 and June 2011 was included. Baseline and stimulated hormonal tests were performed as required for hormonal evaluations following a diagnosis of meningitis. Pituitary function was assessed following a period of 8-135 months (mean 53 months) after bacterial meningitis. Thirty-seven cases (27 male, 15 pubertal) with mean age of 11.1 ± 4.4 years were included. Mean height SDS was 0.01 ± 1.07 and mean BMI SDS was 0.54 ± 1.15 all patients had a SDS above -2 SD. Baseline cortisol and low dose ACTH stimulation revealed normal adrenal functions in all patients. Gonadotropin deficiency was not detected in any of the pubertal cases. Four cases (10.8 %) had low IGF1 and IGFBP3 z-scores (<-2 SD) according to age, sex and Tanner stage, but peak GH response in clonidin test was >10 ng/ml in three of them suggesting neurosecretary dysfunction of GH in these cases. The fourth case has died before the test. No one had TSH deficiency and diabetes insipidus, only one case had mild hyperprolactinemia. Our findings suggest that hypothalamo-pituitary dysfunction is not as common in childhood as in adulthood. The most remarkable finding was neurosecretary dysfunction of GH in some cases.
    Pituitary 12/2013; 18(1). DOI:10.1007/s11102-013-0547-4 · 3.20 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Brucellosis is a public health problem in most countries in the Mediterranean. Involvement of the central nervous system is seen in 4-13% of patients with brucellosis. A 13-year-old girl was admitted because of gait disturbance, diplopia, and dizziness. Her complaints began about 1.5 years ago. The second symptomatic episode repeated about three months ago and the third two months ago. In total, attacks repeated 3 times over 1.5 years. The magnetic resonance imaging (MRI) and the clinical features mimicked multiple sclerosis. The patient was given pulse steroid treatments. After steroid treatment, her gait disturbance and diplopia improved over the short term. Following positive developments, her symptoms recurred. The tests were repeated; the MRI showed increasingly high signal abnormalities, and Brucella melitensis was grown in cerebrospinal fluid. The patient was started on an oral combination of rifampin, doxycycline, and ciprofloxacin. MRI findings improved markedly after nine months of treatment. Although neurobrucellosis is associated rarely with demyelination in adults, this finding has not been reported previously in children or adolescents. Additionally, this case is the first in terms of involvement of the corpus callosum in neurobrucellosis. In this article, we present an unusual case of neurobrucellosis.
    The Turkish journal of pediatrics 11/2013; 55(2):210-3. · 0.43 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Unlabelled: The aim of this study was to determine serotype distribution and investigate antimicrobial resistance patterns of Streptococcus pneumoniae in healthy Turkish children in the era of community-wide pneumococcal conjugate vaccine (PCV7). The study was conducted on 1,101 healthy children less than 18 years of age. Specimens were collected with nasopharyngeal swabs between April 2011 and June 2011. Penicillin and ceftriaxone susceptibilities were determined by E-test according to the 2008 Clinical Laboratory Standards Institute, and serotypes of the isolates were determined by Quellung reaction. The nasopharyngeal pneumococcal carriage rate was 21.9 % (241/1,101). Using the meningitis criteria of minimum inhibitory concentration values, 73 % of the isolates were resistant to penicillin and 47.7 % of them were resistant to ceftriaxone. Half of all pneumococcal isolates were serotyped as 19F (15.2 %), 6A (15.2 %), 23F (10.3 %), and 6B (9.3 %) and surprisingly, no serotype 19A was isolated. Serotype coverage rates of PCV7 and non-PCV7 were 46.2 and 53.8 %, respectively. The most common penicillin- and ceftriaxone-resistant serotypes were 6A, 6B, 14, 19F, and 23F. Penicillin- and ceftriaxone-resistant isolates were more prevalent in serotypes covered by PCV7 than the non-PCV7 serotypes. Conclusion: After the community-wide PCV7 vaccination, more non-PCV7 serotypes were isolated from the carriers compared to the time before PCV7 was used especially the serotype 6A, and the antimicrobial resistance of pneumococci was significantly increased.
    European Journal of Pediatrics 09/2013; 173(3). DOI:10.1007/s00431-013-2156-7 · 1.89 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Secondary capillary leak syndrome is characterized by loss of fluid and proteins to the interstitial space due to different causes, which are related to endothelial damage. Rotavirus is the most common pathogen of diarrhea in childhood, especially during the first years of life. This virus is generally responsible for severe diarrhea and electrolyte imbalance in children. Some complications can also occur during the course of the rotavirus diarrhea. An eight-month-old girl with rotavirus diarrhea admitted to our clinic with severe dehydration. After restoring the intravascular volume, hypoalbuminemia and generalized edema were seen in the recruitment phase of the treatment, which was attributed to secondary capillary leak syndrome. She was successfully treated with prednisolone and discharged from the hospital without any sequelae. Herein, we report an infant with rotavirus diarrhea complicated with secondary capillary leak syndrome, which is an unidentified complication of the disease. To our knowledge, this is the first such case in the literature.
    The Turkish journal of pediatrics 05/2013; 55(1):90-3. · 0.43 Impact Factor
  • Halil Ozdemir · Ergin Ciftci ·

    03/2013; 13(1):45-46. DOI:10.5152/ced.2013.12
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to investigate the effects of pneumococcal conjugate vaccine (PCV7) on nasopharyngeal (NP) carriage rates of Streptococcus pneumoniae in healthy Turkish children. The study was conducted on 1101 healthy Turkish children between 1 month and 18 years of age. The median and mean ages of the children were 25 months (1 month-18 years) and 45.7±49.6 months, respectively. S. pneumoniae was isolated in 241/1101 (21.9%) children included in the study. According to multivariate analysis, being <5 years of age, presence of a child attending a daycare center, recovery from respiratory infection within the last month, low income level of the family, and presence of more children in the family were found to be the risk factors for the NP pneumococcal carriage. The carriage rate of NP pneumococci in healthy children was not influenced by PCV7 in Turkey.
    The Turkish journal of pediatrics 01/2013; 55(6):575-583. · 0.43 Impact Factor

Publication Stats

569 Citations
129.54 Total Impact Points


  • 2015
    • Akdeniz University
      Satalia, Antalya, Turkey
  • 1999-2015
    • Ankara University
      • • Department of Pediatrics
      • • Department of Pediatric Infectious Diseases
      • • Faculty of Medicine
      Engüri, Ankara, Turkey
  • 2011
    • Hacettepe University
      Engüri, Ankara, Turkey
  • 2006
    • University of Leipzig
      Leipzig, Saxony, Germany