Arife Özer

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

Evaluation of Deep Neck Infections in Children - The Journal of Current Pediatrics

Background. Children diagnosed with preseptal cellulitis frequently require hospitalization, leading to both clinical management challenges and substantial healthcare-related costs. The condition often necessitates intravenous antibiotic therapy, radiological imaging, laboratory tests, consultations, and inpatient care, which collectively contribute to the overall economic burden. However, data on the clinical characteristics and cost distribution among pediatric patients remain limited. This study aimed to evaluate both the clinical and economic burden of preseptal cellulitis in hospitalized children and to identify the clinical factors influencing healthcare costs. Methods. This retrospective study included children aged 1 month to 18 years who were hospitalized with a diagnosis of preseptal cellulitis between January 2019 and December 2024. Patients were grouped according to age and presence of predisposing factors. Length of stay, total hospital costs, and cost components were analyzed based on clinical characteristics. Results. A total of 166 patients were included (mean age: 70.1 ± 46.9 months; 62% male). The most common findings were periorbital swelling (96.4%) and erythema (75.3%). Median length of stay was 5 days, with no significant differences by age, sex, or predisposing factors (p>0.05). However, a strong positive correlation was found between length of stay and total cost (rho=0.775, p

This study aimed to evaluate the demographic, clinical, laboratory, microbiological, and radiological characteristics of pediatric brucellosis patients with and without osteoarticular involvement, and to identify associated risk factors and outcomes. A retrospective analysis was conducted on 101 children diagnosed with brucellosis between 2008 and 2022. Data were extracted from patient files and electronic records. Patients were grouped based on the presence or absence of osteoarticular involvement. Of the 101 patients, 52 (51.5%) had osteoarticular involvement. Myalgia (P = .027), low back pain (P < .001), and higher serum standard tube agglutination titers (P = .004) were significantly more common in this group, while abdominal pain was more frequent in patients without joint involvement (P = .007). The time from symptom onset to hospital admission was significantly longer in the osteoarticular group (P = .033). Magnetic resonance imaging confirmed sacroiliitis and hip involvement in 69.2% of relevant cases. In tropical and endemic regions where brucellosis remains a significant public health problem, children presenting with myalgia, back pain, high standard tube agglutination titers, and prolonged symptom duration should be carefully evaluated for osteoarticular brucellosis. Early identification is essential for preventing complications and optimizing treatment.

Background Central line–associated bloodstream infections (CLABSIs) have been widely studied, but the burden of non-CLABSI hospital-onset bacteremia and candidemia (HOB/HOC) in children outside intensive care units (ICUs) remains poorly understood. Methods We retrospectively analyzed pediatric patients (1 month–18 years) admitted to a tertiary referral hospital in Turkey between January 2021 and January 2025. Eligible cases included the first positive blood culture for a non-commensal organism on or after hospital day 4, without central venous catheters, peripherally inserted central catheters, or ICU stay. Demographic, clinical, microbiological, and outcome data were collected. Results Of 14,985 blood cultures, 29 episodes of HOB/HOC met inclusion criteria. The median patient age was 38 months (IQR 11.5–78), with 65.5% under 5 years. The most frequent pathogens were Escherichia coli (17.2%), Staphylococcus aureus (17.2%), Coagulase-negative staphylococci (17.2%), Candida species (13.8%), and Klebsiella pneumoniae (13.8%). Clinical sources included skin/soft tissue infections, peripheral intravenous catheter thrombophlebitis, urinary, and respiratory infections. Patients with HOB/HOC stayed in the hospital a median of 11 extra days for infection treatment. Conclusion Non-CLABSI HOB/HOC significantly contribute to morbidity in pediatric wards, prolonging hospitalization and involving resistant pathogens. Infection prevention should extend beyond central lines to peripheral devices, supported by enhanced surveillance systems and definitions. What is Known: • Hospital onset bacteremia/candidemia are important healthcare-associated infections, with pediatric non-CLABSI cases largely understudied. • Existing literature offers limited epidemiologic and clinical data on non-ICU pediatric HOB/HOC. What is New: • This study characterizes non-CLABSI pediatric HOB/HOC in general wards, predominantly affecting younger children. • The study demonstrates notable pathogen diversity with marked antimicrobial resistance and shows that these infections substantially extend hospitalization duration.

Objective: Influenza is a contagious viral respiratory tract infection that causes severe illness, particularly in high-risk populations such as young children and individuals with pre-existing health conditions. The study aims to identify clinical characteristics and key risk factors associ ated with respiratory support and mortality in children with influenza infection. Materials and Methods: This retrospective, multicenter study was conducted across 33 hos pitals from 19 cities in Türkiye. Data from pediatric inpatients aged <18 years diagnosed with influenza between October 2023 and May 2024 were analyzed. Results: Among 1032 hospitalized children infected with influenza, 394 (38.2%) required res piratory support. The respiratory support group was significantly younger, with a mean age of 3.40 ± 4.37 years, compared to 4.96 ± 4.36 years in the non-respiratory support group (P < .001). The frequency of any underlying disease was significantly higher in the respiratory sup port group (P < .001). Notably, conditions such as neurometabolic disorders (20.3% vs. 9.6%) and pulmonary diseases (7.1% vs. 2.8%) were more common in this group. Influenza A infection and viral coinfections, particularly with respiratory syncytial virus, increased the likelihood of mechanical ventilation and mortality. The mortality proportion of all patients with influenza infection was 1.3% and the influenza vaccine coverage was only 1.1%. Conclusion: These findings highlight the urgent need to incorporate influenza vaccination into the national immunization program, especially for high-risk pediatric populations.