Deniz Ergün

Background: Totally implantable venous access devices are essential for long-term care in pediatric cancer patients, but they can cause catheter-associated bloodstream infections (CLABSIs). While central line bundles have proven effective in preventing CLABSIs in inpatient settings, data on adjunct prevention strategies, such as 70% isopropyl alcohol-impregnated disinfecting caps, in ambulatory pediatric oncology patients are limited. Objective: To assess the impact of 70% isopropyl alcohol–impregnated disinfecting caps on the rate and cost of CLABSIs in ambulatory pediatric hematology-oncology patients with ports. Methods: This study compared 2 distinct periods at an outpatient clinic: control group (n=58) and a study group using 70% isopropyl alcohol–impregnated disinfecting caps (n=34). The primary outcome was the CLABSI rate per 1000 catheter-days. Secondary outcomes included attributable health care costs and cost-effectiveness analysis. Results: The CLABSI rate was 13.55/1000 catheter-days in the control group and 2.05/1000 catheter-days in the study group, reflecting an 84.9% reduction. The cost analysis demonstrated that the intervention was cost-effective, with estimated savings ranging from $2637.68 to $10,916.67 and a return on investment of up to 9.641%. Conclusion: Implementation of 70% isopropyl alcohol–impregnated disinfecting caps resulted in a substantial clinical reduction in ambulatory CLABSI incidence and yielded significant cost savings in this high-risk population.

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

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.

Background: Postexposure prophylaxis (PEP) is critical in preventing HIV acquisition after risky exposures, particularly in pediatric sexual assault victims. Despite its importance, adherence and follow-up remain significant challenges. Objectives: This study evaluates PEP and follow-up adherence and efficacy among pediatric sexual assault victims treated at a tertiary care hospital in Turkey. Methods: A retrospective analysis was conducted on 119 pediatric patients 1 month to 18 years of age, treated between September 2017 and September 2022. Data were collected on demographics, PEP initiation and completion, follow-up rates and serologic testing for HIV. PEP compliance, follow-up adherence and outcomes were analyzed. Results: PEP was initiated in 97% of the eligible 119 patients, with 70% completing the regimen. Compliance showed no significant differences by sex or age. Follow-up adherence decreased progressively, from 55% at the first month to 30% by the sixth month. Nausea and vomiting occurred in one case, indicating a low incidence of side effects. None of the patients seroconverted to HIV. Conclusion: A structured care system involving multidisciplinary collaboration, pioneered by pediatric infectious diseases, can lead to high PEP initiation and completion rates in children. Single-pill PEP regimens may enhance adherence. However, the decline in follow-up rates underscores the need for improved follow-up mechanisms and future interventions.