Aslınur Özkaya Parlakay

Invasive meningococcal disease (IMD) remains a major cause of morbidity and mortality in children. Post-pandemic epidemiological patterns of pediatric IMD are not well defined in Türkiye. This study aimed to evaluate the epidemiology, clinical characteristics, outcomes, and serogroup distribution of pediatric IMD in a large multicenter cohort in Türkiye, comparing the during-COVID and post-COVID periods. This retrospective multicenter hospital-based study included children aged 1 month–18 years hospitalized with laboratory-confirmed IMD in 39 hospitals across 23 provinces. Cases were grouped as during-COVID (January 2020–May 2022) and post-COVID (June 2022–December 2025). A total of 166 patients (median age 25 months; 59.6% male) were included; 25 occurred during-COVID and 141 post-COVID. The number of reported cases in participating centers increased after 2022, with seasonal peaks in winter and early spring. Children under 5 years accounted for 62.7% of cases, and infants (< 1 year) were the largest single age group overall (38.6%). The proportion of children under 5 years was lower in the post-COVID period (58.9% vs 84.0%; OR 0.27, 95% CI 0.09–0.84), indicating a relative shift toward older age groups rather than a reduction in disease burden among infants. Pediatric intensive care admission occurred in 69.9% of cases, and overall mortality was 13.3%. Mortality varied markedly by clinical form, from 1.2% in meningitis alone to 21.7% in combined meningitis and meningococcemia and 38.1% in meningococcemia alone (p < 0.001). Only 2.4% of children had received any meningococcal vaccine before their illness. Serogroup data were available for 60.8% of patients, with grouping coverage differing between periods (32.0% vs 66.0%). Among cases with available serogroup data, serogroup B accounted for 69.9% in the post-COVID period and for half of the eight grouped cases during the pandemic. In unadjusted exploratory analysis restricted to cases with serogroup data, mortality was higher in serogroup B than non-B infections (21.7% vs 3.1%; OR 8.61, 95% CI 1.08–68.8); in an exploratory model adjusting for clinical form, age, and period, with ungrouped cases retained as a separate category, serogroup B remained associated with mortality (aOR 7.59, 95% CI 1.55–75.65). Conclusion: In this multicenter hospital-based cohort, reported pediatric IMD cases increased in the post-pandemic period, with a persistent burden in infants, a relative shift toward older age groups, and predominance of serogroup B among grouped cases. These findings highlight the importance of strengthened surveillance and support further evaluation of meningococcal vaccination strategies, including MenB vaccination. What is Known: • Invasive meningococcal disease remains a severe pediatric infection with high morbidity and mortality, despite treatment. • The COVID-19 pandemic and the subsequent easing of restrictions altered IMD epidemiology globally. What is New: • Reported pediatric IMD cases increased in the post-pandemic period, with a relative shift toward older children while the proportion of infants remained unchanged (38.3% vs 40.0%); serogroup B predominated among cases with an available serogroup result, although differential availability of these data precludes conclusions about change over time. • Mortality was determined principally by clinical form, ranging from 1.2% in meningitis alone to 38.1% in meningococcemia alone, and only 2.4% of children had received any meningococcal vaccine before their illness.

Objective: Mycoplasma pneumoniae (MP) remains an important cause of respiratory tract infections and community-acquired pneumonia in children and has regained prominence in the post–COVID-19 period. We aimed to evaluate pediatricians’ knowledge of pediatric MP infection across key clinical domains and to compare knowledge according to professional experience. Materials and Methods: This single-center, cross-sectional, questionnaire-based study was conducted in November–December 2025. A literature-based, face-to-face survey with 29 multiple-choice items (single best answer) assessed knowledge in four domains: risk factors (5 items), clinical manifestations/complications (8 items), diagnostic tests (6 items), and treatment (10 items). Participants were stratified by experience (0–5 years vs. ≥6 years). Item-level correct response rates were compared using chi-square/Fisher’s exact tests, and domain scores were compared using the Mann–Whitney U test. Results: A total of 126 physicians participated (0–5 years: n=93; ≥6 years: n=33). Domain-level knowledge scores were comparable between groups across risk factors, clinical manifestations/complications, diagnostic tests, and treatment. However, several item-level differences were observed; these item-level comparisons were exploratory. Physicians with ≥6 years of experience more frequently answered correctly questions related to the incubation period, cutaneous manifestations, limitations of serologic testing, and identification of an antibiotic ineffective against M.pneumoniae infection. In contrast, physicians with 0–5 years of experience more frequently answered correctly items concerning post-infection immunity, the most commonly affected age group, M.pneumoniae-associated CNS disease, hospitalization-related knowledge, and management of MP-associated hemolytic anemia. Conclusion: Overall knowledge of pediatric M.pneumoniae infection was comparable across experience strata at the domain level; however, item-level findings should be interpreted cautiously as exploratory. These findings support an institution-wide, high-yield educational package prioritizing diagnostic test interpretation (particularly serology), recognition of extrapulmonary manifestations, and evidence-based antimicrobial selection in the post–COVID-19 period.

Febrile neutropenia (FN) is a frequent and potentially life-threatening complication of chemotherapy in pediatric oncology. Refugee and immigrant children are often considered to be at higher risk for adverse infectious outcomes due to socioeconomic disadvantage, substandard living conditions, and language barriers. This study aimed to compare FN episodes and short-term clinical outcomes between refugee/immigrant and Turkish pediatric oncology patients managed within a universal healthcare system. Materials and Methods: This retrospective, single-center study analyzed 50 FN episodes, with one episode included per patient, occurring between May and July 2022 at a tertiary pediatric oncology center. Patients were stratified by residency status as Turkish citizens (n=31) or refugee/immigrant children (n=19), primarily Syrian refugees under temporary protection. Comparative analyses included demographic characteristics, clinical presentation, microbiological findings, treatment characteristics, length of hospital stay (LOS), and socioeconomic parameters. Group comparisons were performed using Chi-square and Mann–Whitney U tests. Results: Refugee families demonstrated significantly greater socioeconomic disadvantage, with 94.7% having household incomes at or below the minimum wage compared with 38.7% of Turkish families (p<0.001). Blood culture positivity was higher among refugee patients (26.3% vs. 3.2%, p=0.024). Despite these differences, no significant between-group differences were observed in length of hospital stay (10.42 days for Turkish vs. 12.05 days for refugee patients, p=0.335), treatment intensity, or antifungal therapy requirements. Short-term FN-related clinical outcomes during hospitalization were comparable between groups. Conclusion: Despite marked socioeconomic and housing disadvantages and higher rates of documented bacteremia, refugee and immigrant children experienced short-term FN outcomes comparable to those of Turkish patients when managed in a standardized inpatient setting. These findings suggest that system-level factors—such as universal healthcare access, centralized tertiary care, standardized FN protocols, and language support—may help mitigate the impact of socioeconomic disparities on acute infectious outcomes. However, these results are limited to hospitalized FN episodes and should not be extrapolated to long-term cancer outcomes or outpatient care settings.

Objective: Mean platelet volume (MPV) is an emerging inflammatory biomarker; however, its clinical role in pediatric meningitis remains unclear. This study aimed to evaluate the diagnostic and prognostic value of MPV in children with meningitis.Material and Methods: This retrospective case–control study included children aged 0–18 years who were followed with a diagnosis of meningitis between 2012 and 2016. Age- and sex-matched healthy children served as controls. Demographic data, serial laboratory parameters, cerebrospinal fluid (CSF) findings, culture results, and clinical outcomes were recorded. Group comparisons were performed using appropriate parametric and nonparametric tests. A p-value

Aim Infection control measures during the COVID-19 pandemic significantly reduced SARS-CoV-2 spread. These measures, widely implemented nationally and globally, also had a notable impact on the transmission of other viruses. We aimed to evaluate the effect of two different periods of the pandemic on viral respiratory agents and outcomes in newborns diagnosed with respiratory tract infections (RTI) in the neonatal intensive care unit (NICU).Materials and Methods Newborns admitted to the NICU with RTI were included in the study. Demographic, clinical and laboratory results of two separate 6-month periods (October 2020-March 2021 and October 2021-March 2022) were compared.ResultsOf the 141 newborns included in the study, 15 newborns were followed up during the period when infection precautions were strict (Period I) and 126 newborns were followed up during the period when restrictions were removed (Period II). There was no significant difference between the periods in terms of BW, GA, gender, length of hospitalization, radiologic findings and need for respiratory support. There was a significant difference in the distribution of all viral agents (p=0.001). The rate of detection of SARS-CoV-2 as the causative agent was 20% in Period I and 25% in Period II, with no statistically significant difference (p=0.76).ConclusionRelaxation of infection control measures was associated with increased diversity of viral agents causing RTIs in NICU-admitted newborns. These results suggest that strict infection control measures may have temporarily reduced the circulation of various respiratory viruses, highlighting the impact of these precautions on viral transmission dynamics and neonatal outcomes.