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    Clindamycin Hypersensitivity and Management in a Case with Invasive Group A Streptococcal Cellulitis Caused by Chickenpox
    (Aves Yayincilik, Ibrahim Kara, 2019) Durmus, Sevgi Yasar; Tanir, Gonul; Kaman, Ayse; Akcan, Ozge Metin; Demir, Merve
    Chickenpox is commonly known as a benign exenthamatous disease of childhood that causes vesicular rashes. Symptomatic therapy is usually adequate for chickenpox but in some cases secondary bacterial infections constitute the most common cause of morbidity in children. Primer varicella is an important predisposing factor for invasive group A streptococcal infection. In the treatment of invasive group A streptococcal infection generally accepted therapeutic management includes early administration of penicillin in combination with clindamycin, intravenous immunoglobulins and early surgical intervention. In this report we describe a patient who developed clindamycin hypersensitivity during invasive group A streptococcal cellulitis management.
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    Risk Factors of Stenotrophomonas maltophilia Blood Stream Infections: Comparison With Other Gram-Negative Blood Stream Infections in Children
    (Lippincott Williams & Wilkins, 2020) Aydin, Zeynep Gokce Gayretli; Tanir, Gonul; Bayhan, Gulsum Iclal; Teke, Turkan Aydin; Akcan, Ozge Metin; Kaman, Ayse; Durmus, Sevgi Yasar
    Background: Stenotrophomonas maltophilia, is a nonfermentative, aerobic, Gram-negative bacilli which is intrinsically resistance to several antibiotics. Treatment options for this bacteria are quite different from the other Gram-negative bacilli, which can represent a therapeutic challenge. To initiate appropriate empiric treatment and to reduce mortality, differentiation of S. maltophilia from other Gram-negative bacteria is critically important. The aim of this study is to distinguish the risk factors of S. maltophilia blood stream infections (BSI) from other Gram-negative BSI. Methods: This was a retrospective, case-control study. Patients with S. maltophilia BSI were selected as cases and patients with non-S. maltophilia Gram-negative BSI were selected as controls. Demographic and clinical characteristics of patients were recorded. Results: Forty-eight cases with S. maltophilia BSI and 144 controls were enrolled in the study. Risk factors for S. maltophilia BSI compared with the control group includes prior use of antibiotics, especially carbapenem, pediatric intensive care unit stay, mechanical ventilator use, indwelling catheters and duration of hospitalization. Conclusions: Breakthrough infection by S. maltophilia can occur in severely ill patients being treated with carbapenem. In the presence of risk factors, to reduce morbidity and mortality, S. maltophilia should be kept in mind when starting empiric treatment.