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Infectious gastroenteritis is an important cause of morbidity and mortality, especially in nations with middle and low incomes. In a pediatric gastroenteritis patient, the aim was to determine the therapeutic impact of using the Gastrointestinal Panel in our clinical practice. A single-center retrospective study was designed to evaluate children who were admitted to the hospital for gastroenteritis and had a gastrointestinal panel between August 2021 and January 2024. 103 patients who had gastrointestinal (GI) panel results were included in the study. The GI Panel positivity rate among 103 patients was 55.3% (n = 57). Bacterial agents were positive in 25 patients (43.8%), viral agents were found in 11 patients (19.2%), and polymicrobial agents were found positive in 21 patients (36.8%). Escherichia coli (9.1%) was the most common bacterial pathogen, and viral pathogens most frequently included Rotavirus (11.6%) and Norovirus (11.6%). When the effect of the GI Panel test on treatment was determined, the treatment of 51 (49.5%) patients was changed according to GI Panel., Conclusions: In our study, the treatment regimen of many patients was adjusted based on the GI panel results in patients presenting with gastroenteritis. GI panel had an important impact on the patients care and optimization according to the principles of antimicrobial treatment. GI panel tests had several advantages such as speed and diagnostic accuracy as good as stool culture., What Is Known: • Infectious gastroenteritis is a major cause of morbidity and mortality, especially in middle- and low-income countries. • BioFire® FilmArray, Gastrointestinal Panel (BioFire- Biomerieux, France) is a rapid and simple technique that uses nested multiplex PCR to detect gastrointestinal pathogens rapidly., What Is New:   • In this study, the GI Panel test was found to have a cumulative impact on 49.5% (n=51) of the clinician's treatment modalities. • With its speed and diagnostic sensitivity, the GI Panel may provide clinicians with an important tool in the fight against antibiotic resistance by decreasing antimicrobial drug treatment at the children with gastroenteritis., Competing Interests: Declarations. Ethics approval: Institutional approval was obtained from the Institutional Review Board of Dr. Behcet Uz Children’s Training and Research Hospital in accordance with the Declaration of Helsinki. Contributors: All authors listed have contributed significantly to work through substantial contributions to the conception or design of the work or the acquisition, analysis, or interpretation of data for the work and drafting the work or revising it critically for important intellectual content and agree to be accountable for all aspects of the work. We have reviewed the final version of the manuscript and approved it for publication. Consent to participate: Informed consent was obtained from the participants (or, in the case of children under 16 years of age, their parents or legal guardians) to participate in the study. Consent to publish: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Central nervous system infections (CNS) are life-threatening infections in children, requiring urgent intervention and rapid diagnosis. In this study, we aimed to investigate the efficacy of syndromic tests in diagnosing CNS infections and the distribution of viral pathogens in pediatric patients. A total of 145 pediatric patients with a prediagnosis of CNS infection based on clinical findings by a pediatric infectious disease specialist were included in the study. Microscopic examination, biochemical tests, bacteriologic culture, and syndromic test (BioFire® FilmArray® Meningitis/Encephalitis Panel) were performed on cerebrospinal fluid samples obtained from the patients. Nearly half (44.8%) of the patients were younger than one year of age, the median age was 12 months (6-60 months), and the male-to-female ratio was 1.7, with 92 male and 53 female patients. Viral pathogens were observed in most of the 29 (18.8%) patients with syndromic test positivity (n= 23, 79.4%), while bacterial pathogens were detected in 20.6% (n= 6). No fungal pathogens were detected. Bacterial pathogens were Streptococcus pneumoniae [3.4% (5/145)] and Neisseria meningitidis [0.7% (1/145)]. Viruses were enterovirus [6.9% (10/145)], human herpesvirus-6 [5.5% (8/145)], herpes simplex virus type 1 [1.4% (2/145)], cytomegalovirus [0.7% (1/145)], human parechovirus [0.7% (1/145)], varicella zoster virus [0.7% (1/145)]. The main finding in cases with positive syndromic test was fever (n= 19, 65.5%), followed by vomiting (n= 15, 51.7%), convulsion (n= 14, 48.3%) and rash (n= 6, 20.6%). For turnaround time the median was 111 minutes and the mean was 119 minutes. Despite the lack of a performance study including sensitivity and specificity for syndromic testing or alternative tests for viral etiology, our study demonstrates the benefits of syndromic testing in children with presumed CNS infections, such as shortening the diagnostic period and guiding empirical treatment. It also constitutes an affirmative example of laboratory and clinical collaboration.

Introduction: Brucellosis, which is among the endemic regions of Turkey, is a common zoonotic disease. The gold standard in diagnosing brucellosis is culture. We aimed to compare demographic characteristics, risk factors, and clinical and laboratory variables between cases with culture positivity and undetected in culture. Materials and Methods: This single-center study was conducted between January 2007 and April 2022. Clinical and laboratory data of patients with brucella growth in blood culture and patients without growth were compared. Results: A total of 150 patients were included in the study. The median age was 10 (1-18 years). Of the patients, 66 (44%) were female and 84 (56%) were male. Forty (26.7%) of the patients were bacteremic and 110 (73.3%) were nonbacteremic. In the bacteremic group, white blood cell count, platelet, and hemoglobin counts were lower, and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values were higher. In clinical evaluation, fever, hepatomegaly, splenomegaly, and abdominal pain were more common in the bacteremic group. Conclusion: The distinction between bacteremic and nonbacteremic brucellosis can be predicted using laboratory values such as white blood cells, hemoglobin counts, platelet, ALT, and AST, and clinical findings such as fever, abdominal pain, hepatomegaly, and splenomegaly.

Introduction: One of the important problems that lower the diagnostic value of blood culture is contamination with skin organisms. The povidone-iodine, alcohol, and chlorhexidine gluconate alcohol are used for disinfection prior to blood sampling for culture., Methods: The investigator-initiated, open label, single centre, randomised trial compared blood culture contamination rates between two groups of patients in which using a povidone iodine skin-preparation process with the contamination rate for using "2 % chlorhexidine with 70 % isopropyl alcohol" skin-disinfection. The patients who required sampling for blood cultures were included in the study and study period was from 15 March 2023 to 15 July 2023., Results: A total of 400 blood cultures were obtained during the study, including 133 in the study group and 267 in the control group. In the total blood cultures, 11.75 % (n = 47) had microorganism isolation. Among them 39 (9.75 %) were contaminants and 8 (2 %) of them were true pathogens. The contaminant microorganisms were as following; 34 coagulase-negative Staphylococci, 3 Micrococcus spp, and 2 Streptococci viridans. The blood culture contamination rate in the study group was 5.3 % (n = 7) and 12.0 % (n = 32) in the control group, and significantly lower in the study group (p = 0.033). There is no significant difference regarding skin related side effects between two groups., Conclusions: This study, showed that 2 % chlorhexidine gluconate in 70 % isopropyl alcohol is more efficacious in children than 10 % povidone-iodine preparations for disinfecting the skin prior to blood specimen collection for prevention of blood culture contamination., Competing Interests: Declaration of competing interest The authors have no example conflict of interest and no relevant financial relationships to disclose. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (Copyright © 2023 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

Competing Interests: The authors have no funding or conflicts of interest to disclose.

Background: SARS-CoV-2, a respiratory viral disease, is thought to have a more severe course in patients with malignancy and low immune systems., Methods: This prospective single-center study was conducted at the University of Health Sciences Dr Behçet Uz Children's Hospital from September 22 to December 31, 2021. Asymptomatic COVID-19 transmission rates were assessed using SARS-CoV-2 serology in patients with leukemia who had no history of COVID-19 infection., Results: Among the 54 patients, 19 (35.2%) were females and 35 (64.8%) were males. The median age was 5.5 years (min 6 months, max 17 years). Forty-nine (90.5%) of the leukemia patients had acute lymphoblastic leukemia, while 5 (9.5%) had acute myeloid leukemia. Five of the 54 patients had a history of COVID-19 or contact with a positive person. SARS-CoV-2 IgG positivity was detected in 18 (36.7%) of 49 patients with no history of COVID-19 infection., Discussion: Leukemia patients have a high seroconversion for SARS-CoV-2 without showing any symptoms supporting the asymptomatic course of COVID-19 infection in this risk group., Conclusion: As a result, patients with leukemia may have a high rate of COVID-19 seroconversion without showing symptoms., (Copyright © 2023 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

This study aimed to assess the therapeutic effects of implementing the BioFire ® Blood Culture Identification 2 (BCID2) Panel (bioMérieux, Marcy l'Etoile, France) in the clinical practice of children with sepsis. This retrospective cross-sectional study included children from 15 days of age to 18 years old with sepsis and of whom the BCID2 Panel was studied from the positive blood culture. If the antimicrobial treatment was changed according to the results of BCID2 Panel, it was recorded and re-grouped as targeted antimicrobial therapy, de-escalation of the antimicrobial treatment and shifting to another antimicrobial drug if any antimicrobial resistance was detected. Seven-days and thirty-days mortality rate was recorded. Thirty-two patients with 36 septic episodes with positive BCID2 Panel results were included. The median age was 10 months 15 days (ranging from 15 days to 16.5 years). The mean difference between having positive results by the BCID2 Panel and conventional culture methods was 82.2 ± 45.4 h (ranging from 12.3 to 207 h). Effect of the BCID2 Panel on the antimicrobial treatment was detected in 69.4% of the episodes (n = 25). Glycopeptides were ceased at 6 patients, piperacillin/tazobactam was ceased at 6 patients, and cefotaxime was ceased at one patient and de-escalation was achieved in 13 episodes which formed the 36.1% of the initial antimicrobial treatment.   Conclusion: The BCID2 Panel had an important impact on the patients care and optimization according to the principles of antimicrobial stewardship. The BCID2 Panel may be one of the key items for rapid and accurate diagnosis in children with sepsis. Blood culture is still the mainstay for especially detection of antimicrobial drug resistance, while BCID2 tests had several advantages such as speed and diagnostic accuracy as good as blood culture. What is Known: • The BioFire ®  Blood Culture Identification 2 (BCID2) Panel (bioMérieux, Marcy l'Etoile, France) is a well-validated assay that allows for the simultaneous identification of 43 nucleic acid targets associated with bloodstream infections within about 1 h. What is New: • BCID2 Panel had a direct impact on the patient's treatment decision at the 69.4% of the sepsis episodes. • The clinicians received the microbiological results 82.2 h earlier with BCID2 panel compared to blood culture methods with antimicrobial resistance and de-escalation of the antimicrobial drugs was achieved at 13 episodes which formed the 36.1% of the initial treatment., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Severe acute respiratory syndrome coronavirus 2 is reappearing with an increasing number of variants every day; this study aimed to determine the effect of B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), and B.1.617.2 (Delta) variants on hospitalization rates. This single-center study was conducted at the University of Health Sciences Dr. Behçet Uz Children's Hospital from March 11 to August 27, 2021. Variant analyses of symptomatic patients admitted to the hospital who were found to be positive for COVID 19 PCR was performed. Out of 680 cases, 329 (48.4%) were B.1.1.7 variant, 17 (2.5%) were B.1.351/P.1 variant, and 165 (24.2%) were B.1.617.2 variant. One hundred and sixty-nine (24.9%) case variant analysis results were negative. The hospitalization rate of patients with the B.1.617.2 variant was 19.4%, the B.1.351/P.1 variant was 18%, the B.1.1.7 variant was 9.4%, and the negative variant was 10.1%. The B.1.617.2 (Delta) variant, which has become widespread all over the world recently, increases the rate of hospitalization in children., (© 2022 Wiley Periodicals LLC.)

Acute asthma exacerbations (AAE) are episodes characterized by potentially life-threatening and rapidly deteriorating asthma symptoms. Viral respiratory infections are one of the major triggers in the pathophysiology of childhood asthma exacerbations. In this study, we aimed to determine the distribution of viral agents among pediatric AAE patients. One hundred and three AAE patients, aged 5 or older, hospitalized between from February 2017 through February 2020 at Pediatric Immunology and Allergic Diseases Unit were included in this study. Fifty patients (48.5%) were female, and the mean age of the patients was 108.2 months. Viruses were detected in 58 (%56.3) of the patients, in 5 of whom more than one virus type was detected. The most commonly detected virus was human rhinovirus (n=43, 67.1%). Other types included respiratory syncytial virus (n=8; 12.5%), influenza (n=6; 9.3%), human metapneumovirus (n=4; 6.2%), adenovirus (n=1; 1.5%), enterovirus (n=1; 1.5%), and parainfluenza (n=1; 1.5%). Viral agents were detected in 29 out of the 47 patients with allergic asthma, with human rhinoviruses comprising the majority (18 patients). The mean length of hospital stay was 7.89 days. Human rhinovirus is the most common virus that triggers AAE, with similar distributions in allergic and non-allergic asthma. We found no correlation between virus type and the length of hospital stay.

Background: The influenza virus is a significant cause of acute lower respiratory tract infections (LRTI) requiring hospitalization in childhood and leads to severe morbidity and mortality, especially in certain risk groups., Objectives: The study aims to evaluate acute LRTI due to influenza in a tertiary care hospital and the risk factors for hospitalization among Turkish children., Study Design: Children between 1 month and 18 years of age who were hospitalized at Dr. Behçet Uz Children's Hospital between January 2016 and March 2018 with lower respiratory tract infection that tested positive for influenza by PCR were included. Children with viral coinfections were excluded. Patient files were retrospectively scanned from the hospital computerized system in terms of age, underlying diseases, whether antiviral therapy was used, and length of hospital stay. Statistical analysis was performed using SPSS statistical software., Results: The study included 131 patients with a median age of 2 years (1 month-15 years). Sixty-seven (51,1%) patients were younger than two years. Influenza A was isolated in 129 patients and B in 2 patients. Fifty-two patients (39,7%) had underlying medical conditions, and the most common one was malignancies (12/52, 23%). This was followed by neurodevelopmental diseases (9/52, 17,3%), prematurity (9/52 patients, 17,3%), primary immunodeficiency (8/52, 15,4%), asthma (7/52, 13,4%), Down syndrome (4/52, 7,7%), chronic renal disease (2/52, 3,8%) and congenital heart diseases (1/52, 1,9%). The mean length of stay (LOS) was 12,3 ± 9,5 days (2-60 days). The LOS was found to be statistically longer (15,2 ± 12,1 days, 3-60 days) in patients with an underlying disease compared to previously healthy patients (10,4 ± 6,7 days, 2-35 days) (p = 0.01)., Conclusions: Hospitalization due to influenza-related acute LRTI is not an issue only for patients with an underlying medical condition. Vaccination should be considered not only for those with underlying medical conditions but also for healthy children., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Seven clusters of hospital infection due to Salmonella enterica serovar typhimurium were documented in the neonatology clinic of a children's hospital between April 2002 and March 2004. Eighty-one neonates were infected. Three cases were asymptomatic, 73 cases had gastroenteritis as the only clinical condition, and 5 cases had bacteremia associated with gastroenteritis. All isolates from stool and blood samples (n=86) were identified as Salmonella enterica serovar typhimurium. Extended-spectrum beta-lactamase (ESBL) production was determined by clavulanate disk potentiation assay in all isolates. Enterobacterial Repetitive Intergenic Consensus polymerase chain reaction (ERIC-PCR) was performed in 26 selected isolates, which were chosen as being representative of different clusters, to determine the clonal relationship. PCR, isoelectric focusing and sequence analysis revealed the production of CTX-M-3, TEM-1 and SHV-12 by these isolates in 23%, 76.9% and 100%, respectively. None of the isolates had PER beta-lactamase production. Standard infection control measures such as handwashing and disinfection procedures were implemented in initial clusters. During the two-year period, the infection control policy of the hospital was improved with appropriate actions such as assignment of an infection control nurse and increasing the number of staff of the clinic, and finally, with the establishment of an active surveillance program, the clusters were stopped.

Leech infestation can cause many different clinical symptoms such as epistaxis, haemoptysis, haematemesis, and vaginal bleeding. Therefore leech infestation should be considered as a cause of unexplained severe anemia in rural areas where aquatic leeches are common. In this paper we report a case of pharyngeal leech infestation (Limnatis nilotica) presenting with haemoptysis, and epistaxis which resulted in difficulty in making a diagnosis.