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This study aimed to compare the results of flow cytometric urine analysis and urine culture for the rapid diagnosis of urinary tract infections and to determine the leukocyte and bacterial cutoffs that could achieve maximum sensitivity and negative predictive value (NPV) during the newborn and infant periods. This cross-sectional observational study included urine samples submitted for culture from the neonatal intensive care unit and outpatient clinic between April 2019 and December 2021. The urine samples were first inoculated for culture and then analyzed for leukocyte and bacterial counts using a flow cytometric method (Sysmex UF-1000i, Kobe, Japan). Maximum sensitivity and NPV values ​​were determined by examining different bacterial and leukocyte cut-offs with Sysmex UF1000i. A total of 138 urine samples from 103 patients were included in the study. The reasons for urine examinations were prolonged hyperbilirubinemia, sepsis, and insufficient weight gain. Although no association was observed with leukocyte count, a bacterial cut-off of 83.4/µL was identified as the optimal threshold. Diagnostic values, including sensitivity (91.6%), specificity (88.6%), NPV (98.5%), and positive predictive value (PPV) (55%), were satisfactory. Based on current data, we suggest that the Sysmex UF-1000i is a valuable screening tool for detecting UTIs in asymptomatic newborns. Integrating this technology into clinical practice could enhance early diagnosis and treatment, ultimately improving neonatal care outcomes.

Background. Sexual abuse in children can sometimes result in sexually transmitted infections (STIs), which can serve as crucial forensic evidence. Although PCR methods are now accepted as the gold standard for STI screening, they have not yet widely replaced traditional culture methods in Türkiye. This study aims to assess the necessity of implementing PCR-based STI testing at Child Advocacy Centers in Türkiye, where such testing is not routinely available. Methods. Conducted between February and November 2023, this study included children who presented to the Child Advocacy Center of Marmara University Pendik Training and Research Hospital. High-risk victims were identified based on criteria including a history of penetrative sexual abuse and factors such as multiple perpetrators or significant age disparity. Serological tests and genital swabs were collected and analyzed using both bacterial culture methods and a comprehensive STI PCR panel. Results. The study included 20 victims, with a median age of 16 years. STI PCR testing detected pathogens in 19 out of 21 samples, including Chlamydia trachomatis (20%) and Neisseria gonorrhoeae (5%). In contrast, culture methods identified no sexually transmitted pathogens. Conclusion. PCR testing demonstrated significantly higher sensitivity for detecting STIs compared to traditional bacterial culture methods, as expected. Implementing PCR-based STI testing in Child Advocacy Centers is an urgent and essential need for providing an accurate diagnosis and robust forensic evidence, enhancing the care and legal protection of sexually abused children.

Introduction: The increasing prevalence of Gram-negative bloodstream infections in pediatric patients poses significant treatment challenges, particularly from multi-drug resistant (MDR) strains. Despite advances in medical care, mortality from bloodstream infections remains a concern. Our study aims to understand pediatric patients` demographics, clinical conditions, and microorganisms causing Gram-negative infections, as well as identify factors affecting treatment outcomes and mortality. Methodology: A retrospective, observational study of Gram-negative bacteremia, including all patients < 18 years of age, hospitalized during 2022, with documented bacteremia caused by Enterobacteriaceae or non-fermentative bacteria. Results: In total 123 blood cultures from 102 patients were included study. The median age of patients was 22 months, with 85.3% having an underlying medical condition. Common strains were Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa, with 73.2% hospital-acquired infections. Among the isolated species, 28.5% were multidrug-resistant (MDR). The mortality rate was 10.5%. Mortality among patients with antibiotic-resistant isolates was 17.1%. Patients with sepsis had a markedly elevated mortality rate. Additionally, mortality was increased among patients reliant on mechanical ventilation and those with urinary catheters. Furthermore, central venous catheterization was found to be an independent predictor for sepsis (odds ratio: 2.463, 95% confidence interval: 1.095–5.53), while the presence of a urinary catheter was identified as an independent predictor of mortality (odds ratio: 5.681, 95% confidence interval: 1.142–28.249). Conclusions: The study findings highlight a critical need for strategies to reduce MDR Gram-negative infections in children, emphasizing the importance of timely removal of invasive devices and rational antibiotic use to improve patient outcomes.