Severe suppurative otitis media due to Streptococcus pneumoniae serotype 19A in a fully vaccinated infant by age

The routine use of pneumococcal conjugated vaccines (PCVs) in childhood has significantly reduced the frequency of invasive pneumococcal diseases (IPDs). Serotype replacement has occurred, resulting in an increase in nonvaccine serotypes. Despite this changing profile, both invasive and noninvasive cases continue to be seen with strains within the scope of PCV coverage. Although older children with comorbid disease are described as a risky group for vaccine insufficiency, vaccine failure patterns should be described in detail

Geotrichum capitatum septicemia in a hematological malignancy patient with positive galactomannan antigen: case report and review of the literature.

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The effect of SARS-CoV-2 virus on resting-state functional connectivity during adolescence: Investigating brain correlates of psychotic-like experiences and SARS-CoV-2 related inflammation response

This work was supported by The Scientific and Technological Research Council of Turkey (TÜBİTAK) (Grant Number: 120K729 ) to TT.We first aimed to investigate resting-state functional connectivity (rs-FC) differences between adolescents exposed to SARS-CoV-2 and healthy controls. Secondly, the moderator effect of PLEs on group differences in rs-FC was examined. Thirdly, brain correlates of inflammation response during acute SARS-CoV-2 infection were investigated. Eighty-two participants aged between 14 and 24 years (SARS-CoV-2 (n = 35), controls (n = 47)) were examined using rs-fMRI. Seed-based rs-FC analysis was performed. The positive subscale of Community Assessment of Psychotic Experiences-42 (CAPE-Pos) was used to measure PLEs. The SARS-CoV-2 group had a lesser rs-FC within sensorimotor network (SMN), central executive network (CEN) and language network (LN), but an increased rs-FC within visual network (VN) compared to controls. No significant differences were detected between the groups regarding CAPE-Pos-score. However, including CAPE-Pos as a covariate, we found increased rs-FC within CEN and SN in SARS-CoV-2 compared to controls. Among the SARS-CoV-2 group, neutrophil/lymphocyte and thrombocyte*neutrophil/lymphocyte ratio was correlated with decreased/increased FC within DMN and SN, and increased FC within CEN. Our results showed rs-FC alterations within the SMN, CEN, LN, and VN among adolescents exposed to SARS-CoV-2. Moreover, changes in rs-FC associated with PLEs existed in these adolescents despite the absence of clinical changes. Furthermore, inflammation response was correlated with alterations in FC within the triple network system.Türkiye Bilimsel ve Teknolojik Araştırma KurumuPublisher's VersionPMID:3797934

Tularemia in Children, Turkey, September 2009–November 2012

Tularemia, a zoonotic disease caused by Francisella tularensis, is found throughout most of the Northern Hemisphere. It is not well known and is often misdiagnosed in children. Our aim with this study was to evaluate the diagnosis, treatment, and prognosis for 100 children with tularemia in Turkey. The mean patient age was 10.1 ± 3.5 years (range 3–18 years), and most (63%) patients were male. The most common physical signs and laboratory findings were cervical lymphadenopathy (92%) and elevated erythrocyte sedimentation rate (89%). Treatment response was higher and rate of relapse lower for children 5–10 years of age than for those in other age groups. Associated with treatment failure were female sex, treatment delay of ≥16 days, and use of doxycycline. Tularemia is endemic to Turkey, and the number of cases has been increasing among children as well as adults

Influenza viruses types in 2010-2011 winter season and effectiveness of oseltamivir treatment

2010-2011 kış sezonunda influenza benzeri semptomlarla başvuran hastalarda influenza virüs tiplerinin (influenza A, influenza B ve H1N1) dağılımı, klinik özellikleri ve tedavide oseltamivirin etkinliğinin belirlenmesidir. Gereç ve Yöntemler: Çalışmaya Ocak-Mart 2011 tarihlerinde üç farklı merkeze influenza benzeri semptomlarla başvuran 18 yaş altındaki 300 hasta dahil edildi. İnfluenza sorgulama formu oluşturulan hastaların yaşı, influenza aşı durumu, başvuru semptomlarının başlangıç ve bitiş tarihleri, komplikasyonların varlığı, antiviral tedavi ve antiviral tedavi dışındaki kullanılan ilaçlar (antipiretik, antibiyotik vb.), hospitalizasyon durumu, altta yatan kronik bir hastalık olup olmadığı kaydedildi. Tüm hastalardan influenza virüsleri için nazal sürüntü (swab) örnekleri alındı. Örneklerden influenza virüs tipleri için "reverse-transcription" polimeraz zincir reaksiyonu (RT-PCR) çalışıldı. Hastaların bir kısmına RT-PCR sonuçları beklenmeden rastgele oseltamivir tedavisi başlandı ve takibe alındı. Bulgular: Hastalarda başvuru sırasında en sık görülen semptomlar ateş (%87.3), öksürük (%84.7), burun tıkanıklığı (%86.3), burun akıntısı (%83.7), boğaz ağrısı (%32), baş ağrısı (%21.3), kas ağrısı (%16.3) idi. Hastaların 45’ine (%15) mevsimsel influenza aşısı yapılmışken, 255’inin (%85) aşısı yoktu. Hastaların 129’unda (%43) influenza RT-PCR pozitif bulundu ve bunların 71’ine oseltamivir başlanmıştı. İnfluenza pozitif grupta yer alan ve oseltamivir başlanan hastalarda ateş, öksürük, burun tıkanıklığı ve burun akıntısı süresinin istatistiksel olarak daha kısa olduğu saptandı (p<0.002). Oseltamivir tedavisinin semptomların başlangıcından itibaren ilk 48 saatte başlanmasının klinik iyileşme üzerinde daha etkili olduğu gösterildi. RT-PCR pozitifliği olan hastalardaki influenza virüsü tiplerinin dağılımına bakıldığında, 37’sinde (%28.6) H1N1, 44’ünde (%34.1) influenza A, 46’sında (%35.6) influenza B, 2’sinde (%1.5) miks etken saptandı. Etkenler arasında semptom süresi karşılaştırıldığında influenza B’de öksürük (p<0.001), burun tıkanıklığı (p<0.05) ve burun akıntısının (p<0.001) diğer etkenlere göre daha uzun sürdüğü görüldü. Sonuç: Mevsimsel influenza ve H1N1’in tedavisinde oseltamivir etkili bir ajandır. Ancak tedaviye mümkün olan en kısa sürede başlanmalı ve başlamak için test sonuçları beklenmemelidir. (J Pediatr Inf 2012; 6: 1-5)Objective: The aim of this multicentric prospective study was to evaluate the efficacy of a new bioequivalent formulation of oseltamivir for the treatment of influenza A, influenza B and H1N1 during the 2010- 2011 influenza season. Materials and Methods: We compared the symptoms and signs of 300 pediatric patients presenting to three University hospitals with an influenza-like illness, between January and March 2011. Nasal swab specimens were collected from all children and tested by reverse-transcription polymerase chain reaction (RT-PCR) for influenza viruses. After randomization, half of the participants were prescribed oseltamivir, while the other half were observed conservatively. Forty patients who were followed-up for influenza prior to the study were also included into the evaluation. Results: Influenza was confirmed by RT-PCR in 129 children, 71 of whom were prescribed oseltamivir. The durations of symptoms such as fever, cough, nasal congestion and rhinorrhea were significantly shorter for patients who were treated with oseltamivir compared with untreated patients (for all symptoms <0.002). Early initiation of oseltamivir therapy (within 48 hours of the onset of symptoms) was associated with more favorable outcomes and a earlier recovery than in patients for whom treatment was delayed (beyond 48 hours). Thirty-seven patients (28.6%) had H1N1, 44 (34.1%) had influenza A, 46 (35.6%) had influenza B, 1 (0.75%) had H1N1 plus influenza A and 1 (0.75%) had influenza A plus influenza B viruses. In the comparison of the duration of symptoms in different virus types, a statistically significant difference was only observed in patients with influenza B, who had a longer duration of cough (<0.001), nasal congestion (<0.001) and rhinorrhea (<0.001). Conclusion: Oseltamivir is an effective treatment for the management of seasonal influenza and H1N1, and should be initiated immediately without waiting for laboratory confirmation of diagnosis. (J Pediatr Inf 2012; 6: 1-5

The impact of meningococcal conjugate vaccine (MenACWY-TT) on meningococcal carriage in Hajj Pilgrims returning to Turkey

Meningococcal conjugate vaccine was administered for the first time to pilgrims in 2018 in Turkey prior to their departure to the Hajj. This study aimed to determine the effect of vaccination on the prevalence of Neisseria meningitidis carriage among the pilgrims returning to Turkey. This prospective paired (departing and arriving) cohort study included pilgrims aged 10–80 years and compared N.meningitidis carriage before and after pilgrimage. Oropharyngeal samples were collected from 229 pilgrims before departing for Mecca, Kingdom of Saudi Arabia (KSA) and after their return to Turkey. Meningococcal carriage was detected in 3.9% (n = 9) at the time of departure; all positive samples were serogroup B. Upon returning to Turkey,1 (0.4%) pilgrim, who was not a carrier before pilgrimage, was positive for serogroup B. This study is the first to examine meningococcal carriage following the administration of conjugate vaccine to Hajj pilgrims from Turkey

Influenza viruses types in 2010-2011 winter season and effectiveness of oseltamivir treatment

2010-2011 kış sezonunda influenza benzeri semptomlarla başvuran hastalarda influenza virüs tiplerinin (influenza A, influenza B ve H1N1) dağılımı, klinik özellikleri ve tedavide oseltamivirin etkinliğinin belirlenmesidir. Gereç ve Yöntemler: Çalışmaya Ocak-Mart 2011 tarihlerinde üç farklı merkeze influenza benzeri semptomlarla başvuran 18 yaş altındaki 300 hasta dahil edildi. İnfluenza sorgulama formu oluşturulan hastaların yaşı, influenza aşı durumu, başvuru semptomlarının başlangıç ve bitiş tarihleri, komplikasyonların varlığı, antiviral tedavi ve antiviral tedavi dışındaki kullanılan ilaçlar (antipiretik, antibiyotik vb.), hospitalizasyon durumu, altta yatan kronik bir hastalık olup olmadığı kaydedildi. Tüm hastalardan influenza virüsleri için nazal sürüntü (swab) örnekleri alındı. Örneklerden influenza virüs tipleri için "reverse-transcription" polimeraz zincir reaksiyonu (RT-PCR) çalışıldı. Hastaların bir kısmına RT-PCR sonuçları beklenmeden rastgele oseltamivir tedavisi başlandı ve takibe alındı. Bulgular: Hastalarda başvuru sırasında en sık görülen semptomlar ateş (%87.3), öksürük (%84.7), burun tıkanıklığı (%86.3), burun akıntısı (%83.7), boğaz ağrısı (%32), baş ağrısı (%21.3), kas ağrısı (%16.3) idi. Hastaların 45’ine (%15) mevsimsel influenza aşısı yapılmışken, 255’inin (%85) aşısı yoktu. Hastaların 129’unda (%43) influenza RT-PCR pozitif bulundu ve bunların 71’ine oseltamivir başlanmıştı. İnfluenza pozitif grupta yer alan ve oseltamivir başlanan hastalarda ateş, öksürük, burun tıkanıklığı ve burun akıntısı süresinin istatistiksel olarak daha kısa olduğu saptandı (p<0.002). Oseltamivir tedavisinin semptomların başlangıcından itibaren ilk 48 saatte başlanmasının klinik iyileşme üzerinde daha etkili olduğu gösterildi. RT-PCR pozitifliği olan hastalardaki influenza virüsü tiplerinin dağılımına bakıldığında, 37’sinde (%28.6) H1N1, 44’ünde (%34.1) influenza A, 46’sında (%35.6) influenza B, 2’sinde (%1.5) miks etken saptandı. Etkenler arasında semptom süresi karşılaştırıldığında influenza B’de öksürük (p<0.001), burun tıkanıklığı (p<0.05) ve burun akıntısının (p<0.001) diğer etkenlere göre daha uzun sürdüğü görüldü. Sonuç: Mevsimsel influenza ve H1N1’in tedavisinde oseltamivir etkili bir ajandır. Ancak tedaviye mümkün olan en kısa sürede başlanmalı ve başlamak için test sonuçları beklenmemelidir. (J Pediatr Inf 2012; 6: 1-5)Objective: The aim of this multicentric prospective study was to evaluate the efficacy of a new bioequivalent formulation of oseltamivir for the treatment of influenza A, influenza B and H1N1 during the 2010- 2011 influenza season. Materials and Methods: We compared the symptoms and signs of 300 pediatric patients presenting to three University hospitals with an influenza-like illness, between January and March 2011. Nasal swab specimens were collected from all children and tested by reverse-transcription polymerase chain reaction (RT-PCR) for influenza viruses. After randomization, half of the participants were prescribed oseltamivir, while the other half were observed conservatively. Forty patients who were followed-up for influenza prior to the study were also included into the evaluation. Results: Influenza was confirmed by RT-PCR in 129 children, 71 of whom were prescribed oseltamivir. The durations of symptoms such as fever, cough, nasal congestion and rhinorrhea were significantly shorter for patients who were treated with oseltamivir compared with untreated patients (for all symptoms p&lt;0.002). Early initiation of oseltamivir therapy (within 48 hours of the onset of symptoms) was associated with more favorable outcomes and a earlier recovery than in patients for whom treatment was delayed (beyond 48 hours). Thirty-seven patients (28.6%) had H1N1, 44 (34.1%) had influenza A, 46 (35.6%) had influenza B, 1 (0.75%) had H1N1 plus influenza A and 1 (0.75%) had influenza A plus influenza B viruses. In the comparison of the duration of symptoms in different virus types, a statistically significant difference was only observed in patients with influenza B, who had a longer duration of cough (p&lt;0.001), nasal congestion (p&lt;0.001) and rhinorrhea (p&lt;0.001). Conclusion: Oseltamivir is an effective treatment for the management of seasonal influenza and H1N1, and should be initiated immediately without waiting for laboratory confirmation of diagnosis. (J Pediatr Inf 2012; 6: 1-5

2010-2011 Kış sezonunda görülen influenza virüsü tipleri ve tedavide oseltamivir’in etkinliği

Objective: The aim of this multicentric prospective study was to evaluate the efficacy of a new bioequivalent formulation of oseltamivir for the treatment of influenza A, influenza B and H1N1 during the 2010- 2011 influenza season. Materials and Methods: We compared the symptoms and signs of 300 pediatric patients presenting to three University hospitals with an influenza-like illness, between January and March 2011. Nasal swab specimens were collected from all children and tested by reverse-transcription polymerase chain reaction (RT-PCR) for influenza viruses. After randomization, half of the participants were prescribed oseltamivir, while the other half were observed conservatively. Forty patients who were followed-up for influenza prior to the study were also included into the evaluation. Results: Influenza was confirmed by RT-PCR in 129 children, 71 of whom were prescribed oseltamivir. The durations of symptoms such as fever, cough, nasal congestion and rhinorrhea were significantly shorter for patients who were treated with oseltamivir compared with untreated patients (for all symptoms p;lt;0.002). Early initiation of oseltamivir therapy (within 48 hours of the onset of symptoms) was associated with more favorable outcomes and a earlier recovery than in patients for whom treatment was delayed (beyond 48 hours). Thirty-seven patients (28.6%) had H1N1, 44 (34.1%) had influenza A, 46 (35.6%) had influenza B, 1 (0.75%) had H1N1 plus influenza A and 1 (0.75%) had influenza A plus influenza B viruses. In the comparison of the duration of symptoms in different virus types, a statistically significant difference was only observed in patients with influenza B, who had a longer duration of cough (p;lt;0.001), nasal congestion (p;lt;0.001) and rhinorrhea (p;lt;0.001). Conclusion: Oseltamivir is an effective treatment for the management of seasonal influenza and H1N1, and should be initiated immediately without waiting for laboratory confirmation of diagnosis. (J Pediatr Inf 2012; 6: 1-5)2010-2011 kış sezonunda influenza benzeri semptomlarla başvuran hastalarda influenza virüs tiplerinin (influenza A, influenza B ve H1N1) dağılımı, klinik özellikleri ve tedavide oseltamivirin etkinliğinin belirlenmesidir. Gereç ve Yöntemler: Çalışmaya Ocak-Mart 2011 tarihlerinde üç farklı merkeze influenza benzeri semptomlarla başvuran 18 yaş altındaki 300 hasta dahil edildi. İnfluenza sorgulama formu oluşturulan hastaların yaşı, influenza aşı durumu, başvuru semptomlarının başlangıç ve bitiş tarihleri, komplikasyonların varlığı, antiviral tedavi ve antiviral tedavi dışındaki kullanılan ilaçlar (antipiretik, antibiyotik vb.), hospitalizasyon durumu, altta yatan kronik bir hastalık olup olmadığı kaydedildi. Tüm hastalardan influenza virüsleri için nazal sürüntü (swab) örnekleri alındı. Örneklerden influenza virüs tipleri için "reverse-transcription" polimeraz zincir reaksiyonu (RT-PCR) çalışıldı. Hastaların bir kısmına RT-PCR sonuçları beklenmeden rastgele oseltamivir tedavisi başlandı ve takibe alındı. Bulgular: Hastalarda başvuru sırasında en sık görülen semptomlar ateş (%87.3), öksürük (%84.7), burun tıkanıklığı (%86.3), burun akıntısı (%83.7), boğaz ağrısı (%32), baş ağrısı (%21.3), kas ağrısı (%16.3) idi. Hastaların 45’ine (%15) mevsimsel influenza aşısı yapılmışken, 255’inin (%85) aşısı yoktu. Hastaların 129’unda (%43) influenza RT-PCR pozitif bulundu ve bunların 71’ine oseltamivir başlanmıştı. İnfluenza pozitif grupta yer alan ve oseltamivir başlanan hastalarda ateş, öksürük, burun tıkanıklığı ve burun akıntısı süresinin istatistiksel olarak daha kısa olduğu saptandı (p0.002). Oseltamivir tedavisinin semptomların başlangıcından itibaren ilk 48 saatte başlanmasının klinik iyileşme üzerinde daha etkili olduğu gösterildi. RT-PCR pozitifliği olan hastalardaki influenza virüsü tiplerinin dağılımına bakıldığında, 37’sinde (%28.6) H1N1, 44’ünde (%34.1) influenza A, 46’sında (%35.6) influenza B, 2’sinde (%1.5) miks etken saptandı. Etkenler arasında semptom süresi karşılaştırıldığında influenza B’de öksürük (p0.001), burun tıkanıklığı (p0.05) ve burun akıntısının (p0.001) diğer etkenlere göre daha uzun sürdüğü görüldü. Sonuç: Mevsimsel influenza ve H1N1’in tedavisinde oseltamivir etkili bir ajandır. Ancak tedaviye mümkün olan en kısa sürede başlanmalı ve başlamak için test sonuçları beklenmemelidir. (J Pediatr Inf 2012; 6: 1-5

Nasopharyngeal pneumococcal carriage in healthy Turkish children after 13-valent conjugated pneumococcal vaccine implementation in the national immunization program.

In Turkey, pneumococcal conjugated vaccine (PCV) was introduced to the national immunization program as PCV7 in 2008, and was replaced with PCV13 in 2011. The aims of this study were to investigate the effects of PCV13 on nasopharyngeal pneumococcal carriage (NPC) by determining the serotype distribution, and to identify risk factors for carriage, in healthy Turkish children