Fahri Yüce Ayhan

Objective: Blood and blood components are valuable therapeutic products, particularly in pediatric settings where transfusion demand is variable and often urgent. Minimizing blood product wastage is essential to protect limited resources and ensure patient safety. The aim was to determine the rate, causes, and clinical distribution of blood product wastage in a tertiary pediatric hospital over a 1-year period. Methods: This retrospective descriptive study reviewed all red blood cell concentrates (RBCC), apheresis platelet concentrates (APC), fresh frozen plasma (FFP), and cryoprecipitate processed in 2018. Wastage was defined as any allocated but unused unit that became unsuitable for transfusion. Reasons for discard and requesting clinical departments were analyzed. Results: A total of 9 750 components were prepared; 73 (0.75%) were discarded. The wastage rates were RBCC 0.38%, APC 0.54%, FFP 1.8%, and cryoprecipitate 0.6%. The leading discard cause was expiration of shelf life (44%), followed by inappropriate requests (7%) and technical issues such as leakage or hemolysis (6%). Intensive care and emergency units accounted for the highest proportion of wastage. Conclusion: Although the overall wastage rate was low, most losses were preventable. Implementing real-time electronic inventory tools, clinician education, and improved ordering–transfusion synchronization may further reduce wastage and enhance transfusion safety in pediatric care. Cite this article as: Tahta N, Oymak Y, Ayhan FY, et al. Evaluation of blood product wastage rates and causes. Cerrahpaşa Med J 2026, 50, 0087, doi: 10.5152/cjm.2026.25087.

Regular erythrocyte suspension transfusions are still performed in most patients to prevent anemia. In recent years, it has been mentioned that patients are exposed to multiple allogeneic antigens and this leads to changes in the immune system. Understanding the immune regulators responsible for alloantibody development in thalassemia patients will provide appropriate data for the reduction and/or prevention of alloimmunization rate. We aimed to evaluate the association of alloimmunization and immune functions in these patients. Fifty-four patients with thalassemia between the ages of 1-24 were retrospectively analyzed. In these patients, the frequency and types of alloantibodies and the immune functions and demographic characteristics that affect their formation were examined. The rate of alloantibody detection was 29.6%. There was a median interval of 13.7 years from the start of transfusions to alloantibody development. The age of initiation of regular transfusion was significantly late in patients with alloantibody development. We found a strong relationship between alloantibody development and direct Coombs positivity, low C4 and low CD19+ B cell numbers. However, no significant difference was found between the groups in terms of serum IgG, IgA, IgM and C3 levels, the total lymphocyte count, CD3+, CD4+, CD8+, and NK cells counts. We believe that studies at molecular level should be increased and studies should be conducted with a larger number of patients in order to elucidate the immune pathogenesis of alloimmunization and determine the markers that will enable early recognition.

Genel Tanım, Afet Türleri ve Evreleri Kamil KOÇAK Hatice ŞİMŞEK KESKİN Afet ve Salgınların Sağlık Hizmeti Veren Kurumlara ve Tıbbi Mikrobiyoloji Laboratuvarlarına Etkileri Seyfi DURMAZ Mestan EMEK Risk Değerlendirme Yavuz DOĞAN Laboratuvar Tasarımı ve Biyogüvenlik Cemile SÖNMEZ Laboratuvar İçi Atık Yönetimi Nevgün SEPİN ÖZEN Laboratuvar İçi Dezenfeksiyon / Sterilizasyon Yönetimi Berfu TUFANA Aydan ÖZKÜTÜK Biyoemniyet Cemile SÖNMEZ Afet Eylem Planı Oluşturulma Süreci Fahri Yüce AYHAN Tuba Kula ATİK Berrin UZUN Yelda SORGUÇ Örnek, Personel, Cihaz ve Kaynak Yönetimi Taylan BOZOK Yusuf GÖRGÜLÜ Gönül ASLAN Hızlı Tanı Testleri Elif Seren TANRIVERDİ Barış OTLU Tanıl KOCAGÖZ Erken Uyarı Sistemi ve Sendromik Sürveyansla Mikrobiyoloji Laboratuvarının İlişkilendirilmesi (Bilgi Alma ve Bildirim) Leyla GENÇ Elif AKTAŞ İyileşme Döneminde Mikrobiyoloji Laboratuvarının Yeri Yeliz TANRIVERDİ ÇAYCI Gönül ASLAN Mobil ve Sahra Laboratuvarlarının Kurulması ve Sürdürülebilirliği Selçuk KILIÇ Burcu GÜRER GİRAY Meral TURAN Afetlerin Su Kaynaklarına Etkileri ve Su Kaynaklı Salgınlar Umut BERBEROĞLU Ahmet AKTAŞ Bakteriyel Etkenler Neşe İNAL Yeşim BEŞLİ Banu SANCAK Viral Etkenler Melike YAŞAR DUMAN Candan ÇİÇEK Paraziter Etkenler Özlem ULUSAN BAĞCI Metin KORKMAZ Bakteriyel Etkenler Server YAĞCI Yasemin AY ALTINTOP Esma SAATÇI Viral Etkenler Ayşe ARSLAN Candan ÇİÇEK Bakteriyel Etkenler Özlem ULUSAN BAĞCI Yeşim TUYJİ TOK Pınar SAĞIROĞLU Şöhret AYDEMİR Viral Etkenler Mehmet SOYLU Candan ÇİÇEK Paraziter Etkenler Özlem ULUSAN BAĞCI Fadile YILDIZ ZEYREK Metin KORKMAZ Clostridium tetani ve Clostridium perfringens Elvan SAYIN Hastane Enfeksiyonu Etkenleri İlke TOKER ÖNDER Özgen ESER Diğer Bakteriyel Etkenler Erkan SANMAK Sebahat AKSARAY Mantar Enfeksiyonları İlvana ÇAKLOVİCA KÜÇÜKKAYA Ayşe KALKANCI Dilek Yeşim METİN Biyolojik Savaş Ajanları ve Biyoterörizm Selçuk KILIÇ Ahmet ARSLANTÜRK

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.

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.

The challenge of disaster management in healthcare facilities is dealing with the incident’s consequences and maintaining regular operations. Diagnostic and clinical microbiology laboratories have a critical role in the early diagnosis of causative agents of infectious diseases that could spread rapidly in the community and lead to outbreaks. Blood banks are also crucial to maintain the blood supply chain and to cope with the raised demand for blood components because of disaster-related injuries. It is thus necessary to prepare emergency plans, including step-by-step action plans for various disaster scenarios. Even though inconvenient conditions exist during disasters, biosafety and biosecurity precautions still apply, as well as quality control requirements in diagnostic and clinical laboratories and blood banks.