The etiology of bacterial meningitis in Turkey changed after the implementation of conjugated vaccines against Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) in the Turkish National Immunization Program (NIP). Administration of Hib vaccine and PCV-7 (7-valent pneumococcal conjugate vaccine) was implemented in NIP in 2006 and 2009, respectively. In 2011, PCV-7 was replaced with PCV-13. Meningococcal vaccines have not yet been included in Turkish NIP. This prospective study comprised 27 hospitals located in seven regions of Turkey and represented 45% of the population. Children aged between 1 month and 18 years who were hospitalized with suspected meningitis were included. Cerebrospinal fluid (CSF) samples were collected, and bacterial identification was made according to the multiplex PCR assay results. During the study period, 994 children were hospitalized for suspected meningitis, and Hib (n = 3, 2.4%), S. pneumoniae (n = 33, 26.4%), and Neisseria meningitidis (n = 89, 71%) were detected in 125 samples. The most common meningococcal serogroup was MenB. Serogroup W comprised 13.9% (n = 5) and 7.5% (n = 4) of the meningococci in 2015 to 2016 and 2017 to 2018, respectively. Serogroup C was not detected. There were four deaths in the study; one was a pneumococcus case, and the others were serogroup B meningococcus cases. The epidemiology of meningococcal diseases has varied over time in Turkey. Differing from the previous surveillance periods, MenB was the most common serogroup in the 2015-to-2018 period. Meningococcal epidemiology is so dynamic that, for vaccination policies, close monitoring is crucial.
IMPORTANCE Acute bacterial meningitis (ABM) is one of the most common life-threatening infections in children. The incidence and prevalence of ABM vary both geographically and temporally; therefore, surveillance systems are necessary to determine the accurate burden of ABM. The Turkish Meningitis Surveillance Group has been performing a hospital-based meningitis surveillance study since 2005 across several regions in Turkey. Meningococcus was the major ABM-causing agent during the 2015-to-2018 period, during which MenB was the dominant serogroup.
BackgroundHealthcare-associated infections results in increased health care costs and mortality. There are limited studies concerning the distribution of the etiologic agents and the resistance patterns of the microorganisms causing healthcare-associated urinary tract infections (HA-UTI) in pediatric settings.ObjectivesThe aim of this study was to evaluate the distribution and antibiotic susceptibility patterns of pathogens causing HA-UTI in children.Material and MethodsIsolates from 138 children with UTI who were hospitalized in pediatric, neonatal and pediatric surgery intensive care units were reviewed.ResultsMost common isolated organism was Klebsiella pneumoniae (34.1%) and Escherichia coli (26.8%). Among the Pseudomonas aeruginosa, Meropenem and imipenem resistance rates were 46.2% and 38.5%. Extended-spectrum beta-lactamase (ESBL) production was present in 48 Klebsiella species (82.8%). Among ESBL positive Klebsiella species, the rate of meropenem and imipenem resistance was 18.8%, and ertapenem resistance was 45.9%. Extended spectrum beta-lactamase production was present in 27 (72.9%) Escherichia coli species. Among ESBL positive E. coli, the rate of meropenem and imipenem resistance was 7.4%, and ertapenem resistance was 14.8%ConclusionsEmerging meropenem resistance in P. aeruginosa, higher rates of ertapenem resistance in ESBL positive ones in E. coli and Klebsiella species in pediatric nosocomial UTI are important notifying signs for superbug infections.
Background
The aim of this study is to provide a basis for the development of appropriate screening strategies and evaluate the indications of the interferon‐gamma release assay (IGRA) in Bacillus Calmette–Guérin (BCG)‐vaccinated children.
Methods
Children who were examined with both IGRA (QuantiFERON®‐TB Gold Plus) and tuberculin skin test (TST) for tuberculosis infection were included in the study. Underlying medical conditions of the patients were recorded. Cohen's κ was run to determine if there was an agreement between TST and IGRA.
Results
A total of 220 patients with a mean age of 11.05 ± 4.43 years (2.5–18 years) were analyzed. Ninety‐nine patients were immunocompromised and 121 patients were immunocompetent. TSTs and IGRA showed none to the slight agreement in both of the immunocompromised and immunocompetent patients. In the immunocompromised group, 43/99 (43.4%) and the immunocompetent group 35/121 (28.9%) of the tests did not show any correlation.
Conclusion
In a high‐risk setting where the BCG vaccine is mandatory, it may be beneficial to use IGRA primarily in immunocompetent patients. In immunocompromised patients, the use of both the TST and IGRA could increase the efficacy of screening for latent tuberculosis infection.
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