Tuğba Bedir Demirdağ

Introduction‐Aim: The study evaluates the long‐term effect of COVID‐19 on lung function in children, considering symptoms, physical examination findings, radiologic and laboratory evaluations during the acute infection period (AIP). Material and Methods: This prospective, longitudinal, multicenter study involved 270 patients with confirmed SARS‐CoV‐2 infection. Patients underwent pulmonary function tests (PFTs) (spirometry, diffusion capacity of the lung for carbon monoxide (DLCO), and plethysmography) at the 3rd and 6th months of follow‐up. Clinical characteristics, radiological, and laboratory findings during AIP were analyzed to establish the relationship with PFT parameters on long‐term follow‐up. Results: The mean age was 12.97 ± 3.43 years (6–18 years), and 141(52.2%) were girls. Most patients had mild disease, while 193 patients were classified as having pneumonia. Overall mean PFT parameters were normal at the 3rd and 6th months, and FEV ₁ %, FVC%, and DLCOadj% showed statistically significant longitudinal changes. Abnormal DLCOadj was observed in patients with COVID‐19 pneumonia at the 6th month when compared with the non‐pneumonia group ( p = 0.046). At the 3rd month follow‐up, comorbidities were independently associated with abnormal FEV ₁ (OR 6.30, 95% CI 2.61–15.17, p < 0.001) and abnormal FVC (OR 3.47, 95% CI 1.72–7.00, p < 0.001). Respiratory system related abnormal physical examination findings were also independently associated with abnormal FEV ₁ (OR 3.04, 95% CI 1.13–8.21, p = 0.028). Dyspnea showed a borderline association with abnormal FVC (OR 2.11, 95% CI 0.98–4.54, p = 0.057). Pathologic chest radiography, interlobular septal thickening on thorax CT, ground‐glass opacity, fever, dyspnea, and respiratory system related abnormal physical examination findings during the AIP were associated with abnormal PFT parameters during follow‐up. Disease severity scores did not differ significantly between children with normal and abnormal. Conclusions: Most children had preserved mean pulmonary function during follow‐up after SARS‐CoV‐2 infection. However, children with COVID‐19 pneumonia, comorbidities, and respiratory system related abnormal physical examination findings during the AIP may be at increased risk for persistent functional abnormalities. Follow‐up assessment in higher‐risk children should include spirometry, and DLCO measurement should be considered when feasible.

Background. Influenza remains a major cause of morbidity and mortality in children worldwide, yet vaccination coverage is still suboptimal in many countries. We aimed to understand parental awareness, attitudes, and determinants of vaccine uptake to guide effective strategies for increasing coverage and protecting vulnerable pediatric populations. Method. A cross-sectional study was conducted between October 2023 and May 2024 in 38 hospitals across 23 provinces in Türkiye. Data were collected from 5002 families through face-to-face interviews, with 4404 valid responses analyzed. Results. The overall influenza vaccination rate among children was 4.4% (n=195/4404). Vaccination coverage was slightly higher in high-risk groups compared to non-high-risk groups (5.2% vs. 3.5%, p=0.003). Factors positively associated with vaccination uptake included the presence of chronic illness in the child (15.1% in vaccinated vs. 4.7% in unvaccinated, p

Objective: Urinary tract infections (UTIs) are one of the most common bacterial infections in children and can lead to serious complications. This study aimed to investigate the clinical and microbiological characteristics of pediatric UTIs, identify factors associated with renal scarring, analyze trends in antibiotic resistance, and evaluate the impact of urinary anomalies and vesicoureteral reflux (VUR) on recurrence of infection and long-term outcomes.Material and Methods: In this retrospective study, 699 children followed up for UTI were evaluated. Clinical features, laboratory and imaging findings (Ultrasound, voiding cystourethrogram, DMSA renal scan), microbiological data, antibiotic resistance patterns and long-term complications were analyzed. Risk factors for renal scarring were assessed using multivariate logistic regression.Results: Out of the 699 patients followed for UTIs, 530 were female. The median age at the first UTI was 12 months. Renal ultrasonography was performed on all patients. Anomalies were detected in 15.7% of patients. E. coli was the predominant pathogen (82.6%). Renal scarring was detected in 15.7% of patients and was significantly associated with high-grade VUR, recurrent UTI, abnormal US findings, and fever ≥38°C. The prevalence of ESBL-producing bacteria was 2.4%, with ubstantialtly higher ciprofloxacin resistance (28%) compared to non-ESBL bacteria (7.5%). Over time, E. coli resistance to TMP-SMX and amoxicillin-clavulanate declined, whereas cefixime resistance slightly increased.Conclusion: Renal scarring in pediatric UTI is strongly associated with VUR severity, recurrent infections, and urinary tract anomalies. Antibiotic resistance remains a growing concern, particularly among ESBL-producing pathogens. Rational use of antibiotics and individualized risk-based prophylactic strategies are critical to minimizing long-term complications and resistance.

OBJECTIVE: This study aims to assess the adverse events following rotavirus vaccination, which is a major cause of preventable hospitalizations in early childhood. MATERIAL AND METHODS: At Gazi University Faculty of Medicine Hospital, rotavirus vaccination is recommended for all immunocompetent children in the social pediatrics clinic. This study included healthy infants who received a rotavirus vaccine between June 1, 2020, and December 31, 2022. Unforunately rotavirus vaccines are still not included in the national immunization program in Türkiye. The decision on vaccination and vaccine type was made together with families, based on information regarding doses, cost, and efficacy. Patients were monitored daily for one week after each dose of vaccination and contacted six months after the completion of the vaccination series. RESULTS: During the study period, 107 healthy infants (mean age: 4.1 months) received the rotavirus vaccine. Of these, 11 received RotaTeq® and 96 received Rotarix®. Adverse events occurred in 4 infants (3.7%). Among those vaccinated with Rotarix®, one experienced transient vomiting and diarrhea (increased frequency of defecation), another had intermittent bloody stools for one week, and a third had a single episode of bloody stool. One infant vaccinated with RotaTeq® experienced 2 episodes of non-bloody, watery diarrhea. All symptoms occurred after the first dose, resolving without additional treatment or hospitalization. No adverse events previously reported in the literature, such as fever, intussusception, irritability, seizures, apnea, bloating, bronchospasm, nasopharyngitis, bronchiolitis, Kawasaki disease, allergic reactions, or immune thrombocytopenic purpura, were observed following vaccination. CONCLUSION: In conclusion, consisted with existing literature, this study confirms that rotavirus vaccines are well tolerated and safe during infancy. Vaccination has the potential to reduce hospitalization rates, prevent complications associated with rotavirus infection, enhance protection against rotavirus disease. The rotavirus vaccine should be recommended for all infants without contraindications, and parents should be thoroughly informed of its benefits and safety.

Objectives: Acute pyelonephritis (APN) caused by extended-spectrum β-lactamase (ESBL)-positive Enterobacteriaceae poses a growing therapeutic challenge in children, as carbapenems remain the mainstay of treatment even when susceptibility to alternative agents such as amikacin is demonstrated. However, the widespread and inappropriate use of carbapenems can lead to carbapenem resistance. The aim of this study was to compare the clinical efficacy of amikacin and carbapenems in the management of pediatric acute pyelonephritis caused by ESBL-positive Enterobacteriaceae. Methods: We analyzed cases of pediatric acute pyelonephritis caused by ESBL-positive Enterobacteriaceae that were treated with either carbapenems or amikacin over a two-year period. This study compared microbiological cure, clinical improvement, and recurrence rates across the amikacin and carbapenem treatment groups. Results: Fifty-five patients were evaluated. The median age of the patients was 3 years (range, 0.1–13 years). The causative agents were E. coli in 43 cases (78.2%) and Klebsiella spp. in 12 cases (21.8%). All were susceptible to both carbapenem and amikacin in vitro. Twenty patients (36.3%) received a carbapenem and thirty-five (63.7%) received amikacin. Twenty-four (43.6%) had an underlying urological disease. No difference was observed between the groups in terms of microbiological cure, clinical improvement, or recurrence rates. Conclusions: Amikacin may be a potential alternative to carbapenems for treating pediatric ESBL-positive APN when in vitro susceptibility is confirmed.