Objectives: Septic arthritis (SA) is a serious bacterial infection that must be treated efficiently and timely. The large number of culture-negative cases makes local epidemiological data important. Accordingly, this study aimed to evaluate the etiology, clinical characteristics, and therapeutic approach of SA in children in Turkiye, emphasizing the role of real-time polymerase chain reaction (PCR) techniques in the diagnosis. Methods: In this multi-center, prospective study, children hospitalized due to SA between February 2018 and July 2020 in 23 hospitals in 14 cities in Turkiye were included. Clinical, demographic, laboratory, and radiological findings were assessed, and real-time PCR was performed using synovial fluid samples. Results: Seventy-five children aged between 3 and 204 months diagnosed with acute SA were enrolled. Joint pain was the main complaint at admission, and the most commonly involved joints were the knees in 58 patients (77.4%). The combination of synovial fluid culture and real-time PCR detected causative bacteria in 33 patients (44%). In 14 (18.7%) patients, the etiological agent was demonstrated using only PCR. The most commonly isolated etiologic agent was Staphylococcus aureus, which was detected in 22 (29.3%) patients, while Streptococcus pyogenes was found in 4 (5.3%) patients and Kingella kingae in 3 (4%) patients. Streptococcus pyogenes and Kingella kingae were detected using only PCR. Most patients (81.3%) received combination therapy with multiple agents, and the most commonly used combination was glycopeptides plus third-generation cephalosporin. Conclusions: Staphylococcus aureus is the main pathogen in pediatric SA, and with the use of advanced diagnostic approaches, such as real-time PCR, the chance of diagnosis increases, especially in cases due to Kingella kingae and Streptococcus pyogenes.

Aşı enfeksiyon hastalıklarından korunmanın etkin ve güvenli aynı zamanda da en kolay yollarından biridir. Her gün farklı hastalıklarının tanımlandığı, yeni tedavi yöntemlerine bir yenisinin eklendiği modern tıbbın en parlak dönemlerinden birinin yaşandığı günümüze enfeksiyon hastalıklarının önlenmesinde halen temiz su kaynaklarının sağlanması dışında en etkili yöntem aşı uygulamalarıdır. Aşı uygulamaları aynı zamanda koruyucu sağlık hizmetleri içinde de önemli bir yer tutmaktadır. Aşı sadece bireysel koruma sağlamakla kalmaz toplum genelinde aşı uygulaması belirli oranların üzerine çıkartılabildiğinde toplumsal bağışıklığın da oluşmasını sağlar. Toplumsal bağışıklık sağlanmasından bir sonraki adım ise herhangi bir mikroorganizmanın eradike edilmesi yani neden olduğu hastalığın ortadan kalkmasıdır. Bu yazıda ülkemizde sağlık bakanlığı tarafınca önerilen ve uygulanan çocukluk çağı aşı programında yer alan aşılardan, uygulama özelliklerinden ve uygulama öncesinde ya da sonrasında dikkat edilmesi gereken durumlardan bahsedilecektir.

Objective This study aimed to investigate the frequency of latent and active tuberculosis (TB) in pediatric patients receiving anti-tumor necrosis factor (TNF)-α therapy. Methods Patients younger than 18 years with various inflammatory diseases and treated with anti-TNF-α agents in the past five years were included in the study. The patients' ages, follow-ups, medications received, clinical and laboratory findings, and treatments applied were recorded retrospectively. Results Of the 160 patients included in the study, 78 (48.8%) were girls. The mean age was 139.54 ± 48.74 (30–226) months. Sixty (37.5%) patients had inflammatory eye disease, 55 (34.4%) had rheumatologic and autoimmune disease, and 45 (28.1%) had inflammatory bowel disease. As anti-TNF-α treatment, 67 (41.9%) patients received adalimumab, 50 (31.2%) received infliximab, and 43 (26.9%) received etanercept. As a result of TB screening performed prior to the treatment, 44 (25.4%) patients were started on isoniazid treatment with the diagnosis of latent TB. During follow-up, latent TB infection was detected in 16 (9.2%) patients and isoniazid treatment was started. The time to develop latent TB under anti-TNF-α treatment ranged from 3 to 28 months. During the treatment, active TB infection developed in two (1.2%) patients and anti-TB treatment was initiated. Conclusion It is of vital importance to evaluate patients receiving, or planned to receive, anti-TNF-α treatment, for TB infection and to initiate appropriate treatments if latent or active TB infection is identified.