Comparison of QuantiFERON-TB gold in-tube test with tuberculin skin test in children who had no contact with active tuberculosis case.

INTRODUCTION: In this study, we aimed to compare QuantiFERON-TB gold in-tube test (QFT-GIT) and tuberculin skin test (TST) as a diagnosis of latent tuberculosis infection in the children with Bacille Calmette-Guerin (BCG) vaccine. MATERIALS AND METHODS: We evaluated 81 children in the study who have positive TST result without a known history of tuberculosis contact from 2008 to 2011 prospectively. Patients were separated into groups according to their ages, the reason of TST application, number of BCG vaccination scars and diameter of TST induration. Posteroanterior, lateral chest radiographies and computerized tomography, if necessary, were performed. RESULTS: The study consists of 48 (59.3%) boys and 33 (40.7%) girls with a mean age of 94.8 ± 51.9 months (ranged from 6 to 193 months). Sixty nine (85.2%) children had one and 12 (14.8%) had two BCG vaccination scars. The TST induration diameters were 15-19 mm in 65 (80.2%) children and ≥ 20 mm in 16 (19.8%) children. QFT-GIT positivity was found in 12 (14.8%) of the evaluated patients. QFT-GIT positive patients were treated with triple anti-tuberculosis regime or isoniazid (INH). In three years period of study, there were no tuberculosis disease observed among the children who had not been treated with anti-tuberculosis drugs. CONCLUSION: As a result of the study it is suggested to confirm positive TST results with tests based on interferon-gamma (IFN-γ) because it can reduce false positive diagnosis and treatment of latent tuberculosis infection, thus adverse reactions of drugs, in countries where BCG vaccination is routinely recommended especially for low risk children.

The effect of a multispecies synbiotic mixture on the duration of diarrhea and length of hospital stay in children with acute diarrhea in Turkey: single blinded randomized study.

Probiotics have been successfully used for the treatment of acute diarrhea in children and this effect depends on the strains and dose. The aim of this study was to assess the effect of a synbiotic mixture on the duration of diarrhea and the length of hospital stay in children with acute watery diarrhea. This is a prospective randomized, multicenter single blinded clinical trial in hospitalized children with acute watery diarrhea. All children were treated with conventional hydration therapy with or without a daily dose of a synbiotic (2.5 × 10(9) CFU live bacteria including Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum, Bifidobacterium longum, Enterococcus faecium, and 625 mg fructooligosaccharide) for 5 days. The primary endpoint was duration of diarrhea and duration of hospitalization was the secondary endpoint. Among 209 eligible children, 113 received the synbiotic mixture and 96 served as a control. The duration of diarrhea was significantly shorter (∼36 h) in children receiving the synbiotic group than the controls (77.9 ± 30.5 vs. 114.6 ± 37.4 h, p < 0.0001). The duration of hospitalization was shorter in children receiving the synbiotic group (4.94 ± 1.7 vs. 5.77 ± 1.97 days, p = 0.002). The effect of synbiotic mixture on diarrhea started after 24th hours and stool frequency significantly decreased after 24th and 48th hours. The percentage of diarrhea-free children is significantly higher in synbiotic group at 48th and 72nd hours of synbiotic group. In conclusion, this study showed a reduction in diarrhea duration by approximately 36 h and a reduction in the duration of hospitalization with approximately 1 day in children with acute diarrhea with this synbiotic mixture.

[Three Pediatric Cases of Leishmaniasis with Different Clinical Forms and Treatment Regimens]. / Klinik Formlari ve Tedavi Rejimleri Farkli Üç Pediyatrik Leishmaniasis Olgusu.

Several clinical syndromes caused by an obligate intracellular parasite Leishmania spp. subsumed under the term leishmaniasis. Leishmaniasis is endemic in Turkey and the neighboring countries Iran, Iraq, and Syria. Leishmania spp. causes three main clinical forms: cutaneous, mucocutaneous, and visceral disease. The clinical forms may vary by species and/or region of acquisition. Two forms are observed in Turkey; visceral leishmaniasis and cutaneous leishmaniasis. Two cases of cutaneous leishmaniasis with different treatment regimens and a case of visseral leishmaniasis associated with hemophagocytic lymphohistiocytosis are presented in this report.

[Coexistence of Pulmonary Hydatid Cyst and Mycoplasma pneumoniae Pnömonia in a Child]. / Akciger Kist Hidatigine Eslik Eden Mycoplasma pneumonia Pnömonili Çocuk Olgu .

Hydatid cyst is a zoonotic disease and endemic in Turkey. The disease can involve any organ. The most common involved organ is lung in childhood. Hydatid cyst of lung may be asymptomatic or may be sometimes ruptured or infected. Secondary bacterial infections associated with the hydatid cyst are well known. A previously not reported pediatric case of hydatid cyst with Mycoplasma pneumoniae pneumonia is described in this report. It is emphasized that M. pneumoniae should be kept in mind as a cause of infected hydatid cyst which is unresponsive to beta-laktam antibiotics.

The clinical characteristics and treatment of pertussis patients in a tertiary center over a four-year period.

We performed a retrospective study of pertussis patients seen during the period July 2007-December 2011. All patients were microbiologically confirmed through polymerase chain reaction (PCR) or culture. Thirty one patients with positive Bordetella spp. culture or PCR were identified, with a median age of two months. Seventeen patients had received no pertussis vaccination. The most frequent symptoms were paroxysmal cough (100%) and cyanosis (87.1%). The mean duration of the symptoms prior to admission was 12.8 ± 8.0 days. Leukocytosis and thrombocytosis were detected in 64.3% and 67.9% of the 28 hospitalized patients, respectively. Erythromycin had been given to eight patients and clarithromycin to 23 patients. The mean hospital stay was 9.5 ± 5.5 days (range: 3 to 28 days). No patients were readmitted or died. We believe that patients with characteristic paroxysmal cough with cyanosis but no fever should alert clinicians to the possibility of pertussis, and they should be treated without delay. PCR assay provided additional benefit in the diagnoses of the study patients.

Nosocomial infections in the general pediatric wards of a hospital in Turkey.

The aims of this study were to determine the prevalence, type, and clinical features of nosocomial infections (NIs), their etiological distribution, and the antibiotic resistance patterns of causative organisms in the general pediatric wards of a hospital in Turkey over a 3-year period. The Hospital Infection Control Committee NI surveillance reports were used as a database. NIs were detected in 171 (2.25%) of the 7,594 hospitalized patients. Some of these patients experienced more than 1 episode, and thus, the total NI episodes were 229. Patients' age varied from 1 to 144 months (mean ± standard deviation, 14.5 ± 23.6 months). The NI rate was 3.02%, and the NI density was 3.17/1,000 patient days. The most frequent NIs were lower respiratory system infections, blood stream infections, and urinary tract infections. Gram-negative organisms were the most frequently isolated agents. Of the 171 patients with NIs, 47 (27.5%) died.