Ahmet Yasin Güney

Pertussis resurged globally, after the relaxation of COVID-19 measures, underscoring its continued relevance as a public health concern, yet data remain li

Objective: Data on pediatric residents’ awareness and knowledge of childhood tuberculosis in Türkiye are limited. This study aimed to evaluate the awareness and knowledge levels of pediatric residents regarding childhood tuberculosis at Ankara City Hospital. Materials and Methods: This cross-sectional study was conducted between August and September 2023 among pediatric residents at Ankara Bilkent City Hospital. A 15-item online multiple-choice questionnaire assessed knowledge related to epidemiology and prevention, clinical–laboratory–imaging evaluation, treatment, and prophylaxis of childhood tuberculosis. Incomplete or unsubmitted questionnaires were excluded from the analysis. Results: A total of 172 pediatric residents participated in the study, of whom 72.7% were female. Eighty-six residents (50.0%) were classified as junior and 86 (50.0%) as senior. Senior residents demonstrated significantly higher correct response rates than junior residents regarding incorrect statements about BCG vaccination (53.5% vs. 38.4%, p=0.047), definition of close contact in tuberculosis (91.9% vs. 79.1% p=0.017), interpretation of abnormal PPD values (93.0% vs. 76.7%, p=0.003), microbiological diagnostic methods (80.2% vs. 58.1%, p=0.002), and typical radiographic findings in childhood pulmonary tuberculosis (89.5% vs. 74.4%, p=0.010) (p<0.050 for all). Correct response rates increased progressively with advancing residency year (X2 : 37.295, df:1, p<0.001). Conclusion: Senior pediatric residents demonstrated significantly higher knowledge levels regarding childhood tuberculosis compared with junior residents. These findings highlight the importance of structured and continuous educational programs beginning early in residency and reinforced throughout training. Given the endemic nature of tuberculosis in Türkiye, targeted and regularly updated educational interventions may improve early recognition, diagnostic accuracy, appropriate treatment, and overall clinical outcomes. Future multicenter studies incorporating key domains of tuberculosis knowledge—epidemiology and prevention, clinical–laboratory–imaging evaluation, and treatment and prophylaxis—may help identify regional gaps and guide standardized educational strategies.

Objective: Brucellosis, endemic in Türkiye, requires physicians’ awareness for early recognition, diagnosis, and treatment. This study aimed to assess pediatric residents’ knowledge and awareness of brucellosis. Material and Methods: Between August and September 2023, pediatric residents with 0–48 months of training at Ankara Bilkent City Hospital were surveyed using an online 15-item, cross-sectional, multiple-choice questionnaire covering demographics, clinical findings, diagnosis, treatment, and prophylaxis. Each item included four response options reflecting different diagnostic or therapeutic approaches. Incomplete or unsubmitted forms were excluded. Results: A total of 174 residents participated (73% female). Of these, 84 (48.3%) were senior and 90 (51.7%) junior. Senior residents had significantly higher correct response rates than juniors regarding complications (88.1% vs. 83.3%), clinical symptoms (91.1% vs. 70.2%), laboratory findings (77.8% vs. 58.3%), diagnostic serology (52.2% vs. 28.6%), magnetic resonance imaging (MRI) for sacroiliitis (83.3% vs. 65.5%), antibiotic combinations (72.2% vs. 50.0%), and treatment of spondylitis (47.8% vs. 23.8%) (p<0.050 for all). Knowledge improved progressively with residency year (linear-by-linear association, p<0.001). Conclusion: Senior residents demonstrated significantly greater knowledge of brucellosis compared to juniors. These results emphasize the importance of structured, continuous education that begins early in residency and is reinforced periodically. Given the endemic nature of brucellosis in Türkiye, targeted and regularly updated training programs for pediatric residents may improve recognition, diagnostic accuracy, appropriate treatment, and clinical outcomes. Future multi-center studies may better reflect regional differences in awareness and training.

Evidence on the timing and burden of haematological adverse events with intravenous linezolid in children remains limited. We retrospectively evaluated paediatric inpatients aged 1 month and 18 years who received ≥ 3 days of IV linezolid at a tertiary children’s hospital (September 2019–December 2022). Primary outcomes were anaemia and thrombocytopenia, defined a priori. Among 261 patients (median age, 6.9 years), 48.3% were treated in the PICU, and 39.1% had haematology–oncology disorders; the median treatment duration was 14 days. Anaemia (56.7%) and thrombocytopenia (41.8%) were the most common conditions, typically occurring in the first week. In multivariable models, anaemia was associated with concomitant myelotoxic drugs, prior exposure to glycopeptides, and concurrent thrombocytopenia; thrombocytopenia was associated with longer treatment duration and concurrent anaemia. Age-stratified analyses revealed similar early onset (median 6–7 days) across strata, with a higher frequency of thrombocytopenia in the youngest group, paralleling the more frequent concomitant use of myelotoxic therapy. In a restricted cohort excluding chemotherapy/HSCT and any myelotoxic agent (including meropenem), event rates declined while the early-onset pattern persisted. Analyses by treatment-duration categories (≤ 10, 11–14, ≥ 15 days) in patients with normal renal/hepatic function suggested a later onset of thrombocytopenia in the ≥ 15-day group; this subgroup also had the lowest rates of myelotoxic co-therapy, haematology–oncology comorbidity, and PICU admission, warranting cautious interpretation. Conclusions: IV linezolid was frequently associated with early haematological toxicity, amplified by concomitant myelotoxic therapy. Sensitivity and exposure–proxy analyses support the robustness of the signal but highlight residual confounding; prospective studies with exposure monitoring are needed to establish causality. What is Known: • In children, haematological adverse events are the most frequent toxicities of linezolid; thrombocytopenia is typically reported after week 1. • Paediatric evidence is limited and often confounded by concomitant myelotoxic therapies What is New: • In paediatric inpatients on IV linezolid, anaemia and thrombocytopenia often occur in week 1, with anaemia prominent when myelotoxic co-therapy or prior glycopeptides are present. • In a restricted cohort excluding myelotoxic co-therapy/chemotherapy, event rates declined, yet early onset persisted, supporting robustness beyond confounding.

This study aimed to determine the clinical and laboratory characteristics of hospitalized pediatric patients with skin and soft tissue infections (SSTIs) associated with Staphylococcus aureus and to compare parenteral antibiotic therapies in terms of clinical outcomes. This single-center retrospective study analyzed patients aged 1 month to 18 years who were treated for S. aureus-associated SSTIs at Ankara Bilkent City Children's Hospital between September 2019 and September 2022. A total of 89 patients were included. Infections were caused by methicillin-susceptible (S. aureus, MSSA; n=54, 60.7%) and methicillin-resistant (S. aureus, MRSA; n=35, 39.3%). Compared to the MSSA group, the MRSA group had significantly higher rates of central venous catheter-related infections, prior hospitalizations, and complications (34.1% vs. 11.1%, 62.9% vs. 24.1%, and 28.6% vs. 5.6%, respectively; p=0.010, p=0.010, p=0.003). No significant difference in clinical outcomes was observed between patients treated with vancomycin or teicoplanin in the MRSA group. In the MSSA group, clinical outcomes were similar between patients who received beta-lactam/beta-lactamase inhibitors and third-generation cephalosporins. However, those treated with ampicillin-sulbactam had lower recurrence and complication rates compared to those treated with piperacillin-tazobactam (0% and 0% vs. 25% and 25%, respectively; p=0.029). Teicoplanin may be a reasonable option for treating MRSA-related SSTIs due to comparable clinical outcomes to vancomycin. For MSSA-related SSTIs, beta-lactam/beta-lactamase inhibitors such as ampicillin-sulbactam, piperacillin-tazobactam, and third-generation cephalosporins may also be appropriate treatment options with satisfactory results.

Purpose This study aimed to evaluate the clinical characteristics, antibiotic susceptibilities, therapeutic approaches, and outcomes of paediatric patients with A. lwoffii bacteremia. Methods A case series was conducted of paediatric patients diagnosed with A. lwoffii bacteremia between September 2019 and December 2022. Demographic data, underlying diseases, sources of infection, antimicrobial susceptibility profiles, treatment modalities, and clinical outcomes were analysed. Results A total of 12 patients were included, with 58.3% female and a median age of 24 months (IQR: 11-58.5). Overall, 91.7% of isolates were susceptible to amikacin, 83.3% to ceftazidime, 83.3% to colistin, 66.6% to meropenem, 66.6% to piperacillin–tazobactam, and 100% to tigecycline. Three patients received combination antibiotic therapy and nine patients received monotherapy. Antibiotic lock therapy (ALT) was successfully applied in one patient with catheter-related bloodstream infection (CRBSI) whose central venous catheter (CVC) could not be removed. The median infection-related length of hospital stay was 10 days (IQR: 10-14 days). The median duration of bacteremia was 2 days (IQR: 2-3). No cases of persistent bacteremia, recurrence, or infection-related mortality were observed. Susceptibility-guided monotherapy or combination therapy resulted in favourable outcomes in all cases, underscoring the importance of pathogen-directed treatment. Conclusion Acinetobacter lwoffii remains an important pathogen of hospital-acquired bacteraemia in hospitalised children. Treatment with broad-spectrum beta-lactam antibiotics, either as monotherapy or combined with amikacin or colistin, appears effective.

Objective: This study aimed to examine the clinical and laboratory features, antibiotic susceptibilities, treatment characteristics, and outcomes of pediatric patients with Sphingomonas paucimobilis bacteremia. Material and Methods: This single-center, retrospective study included patients aged between 1 month and 18 years who were treated for Sphingomonas paucimobilis bacteremia between September 2019 and December 2022. Results: The study population included 12 pediatric patients with S. paucimobilis bacteremia. The median age of the patients was 28.5 months (range 7-215 months) and 50% were male. All patients had hospital-acquired infections (HAIs). The presence of comorbidities such as hematological-oncological malignancies, neurological disorders, burns and immunological disorders, the presence of a central venous catheter and a history of hospitalization within the last 12 months were prominent risk factors. Bacterial isolates were susceptible at different rates to antibiotics used as follows: piperacillin-tazobactam (83.3%), ceftazidime (91.7%), cefepime (91.7%) and meropenem (100%). The patients were treated with meropenem, cefepime, ceftazidime and piperacillin-tazobactam and the median duration of systemic antibiotic treatment was 10 days (range 10-14 days). Central venous catheters (CVCs) were removed in 3 patients who developed catheter-related bloodstream infections (CRBSIs). Persistent bacteremia, recurrence and 30-day mortality were not observed in any patient. Conclusion: Sphingomonas paucimobilis remains an important opportunistic pathogen of hospital-acquired bacteremia, especially in children with risk factors. Successful treatment seems possible with systemic antibiotic therapy and removal of CVC in the presence of CRBSI.

Objective: The index of cardio-electrophysiological balance (iCEB) is a new non-invasive marker that can be used to predict malignant ventricular arrhythmias. Pediatric studies on iCEB are limited in number. Our study aimed to determine the range of its values in different age groups among school-age children. Material and Methods: The study included patients aged 5-17 admitted to Gülhane Training and Research Hospital Pediatric Cardiology Outpatient Clinic between March 2020 and March 2022 without a history of chronic disease, cardiac disease, arrhythmia, or cardiac surgery. Participants were categorised into ages 5-8, 9-12, and 13-17. The iCEB and iCEBc values were calculated and compared between groups. Results: The total number of 1303 cases were categorised into the 5-8 (n=270), 9-12 (n=389), and 13-17 (n=644) age groups. The mean iCEB and iCEBc values for all age groups were 4.39±0.53 and 5.16±0.53, respectively. Any difference was not detected among age groups of 5-8, 9-12, and 13-17 years in terms of iCEB and iCEBc values (4.42±0.56, 4.39±0.53 and 4.39±0.52 vs. 5.19±0.56, 5.15±0.55 and 5.16±0.52, respectively). However, a significant difference was found between male (n=699) and female (n=604) patients in terms of mean iCEB (4.23±0.52 vs. 4.59±0.47) and iCEBc (4.98±0.53 vs. 5.38±0.46) values (p <0.001). Conclusion: iCEB and iCEBc values in school-age children did not differ according to age groups. However, these values differed between boys and girls. This study is the first to reveal normal ranges of iCEB and iCEBc values in school-age children.