The Turkish journal of pediatrics最新文献

{"title":"Pediatric recurrent intracranial hypertension secondary to All-Trans Retinoic Acid treatment in a patient with acute promyelocytic leukemia: value of retinal nerve fiber layer thickness in management.","authors":"Pınar Yavuz, Güliz Fatma Yavaş, Selin Aytaç, Dilek Yalnızoğlu, Şule Ünal Cangül, Göknur Haliloğlu","doi":"10.24953/turkjpediatr.2026.6693","DOIUrl":"https://doi.org/10.24953/turkjpediatr.2026.6693","url":null,"abstract":"<p><strong>Background: </strong>All-trans retinoic acid (ATRA) is an essential agent in the treatment of acute promyelocytic leukemia (APL). However, careful monitoring is required due to its potential side effects, particularly intracranial hypertension (IH).</p><p><strong>Case presentation: </strong>Here, we report a 15-year-old girl who presented with headache, blurred vision, vomiting, and was found to have left homonymous hemianopsia and an acute cerebral infarct. Etiological investigations revealed acute promyelocytic leukemia and treatment with ATRA was initiated. However, this treatment was complicated by repetitive episodes of IH, which improved with discontinuation of ATRA but recurred whenever reinitiation was attempted. Despite this side effect, the patient was able to complete the planned ATRA course under medical treatment of IH, guided by retinal nerve fiber layer (RNFL) thickness measured using optical coherence tomography (OCT).</p><p><strong>Conclusions: </strong>Changes in papilledema were detected on OCT earlier than on clinical examination. This case illustrates the reversibility of IH secondary to ATRA therapy, the feasibility of completing ATRA treatment despite the side effect of IH, the importance of medical treatment for IH in combination with appropriate dose adjustments, and the accuracy and convenience of RNFL thickness as a biomarker for treatment efficiency. Managing IH in the context of a chronic systemic disorder requires a collaborative approach, close follow-up, and individualized management.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"68 3","pages":"501-514"},"PeriodicalIF":0.0,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular manifestations in newly diagnosed acute leukemia: diagnostic performance of age, hemoglobin and platelets for retinal haemorrhages.","authors":"Ali Fettah, Volkan Köse, Aslıhan Yüce Sezen, Caner Kara, Onur Mert Çelik, Fatma Tuba Yıldırım","doi":"10.24953/turkjpediatr.2026.7154","DOIUrl":"https://doi.org/10.24953/turkjpediatr.2026.7154","url":null,"abstract":"<p><strong>Background: </strong>Ocular involvement in the diagnosis of leukemia is clinically important but has been reported variably. Our aim was to define its prevalence and spectrum and to identify hematologic predictors, specifically age, hemoglobin level (Hb), platelet count (PLT), mean platelet volume (MPV), and platelet mass index (PMI).</p><p><strong>Methods: </strong>This retrospective, single-center study evaluated all newly diagnosed leukemia patients between January 2023 and March 2025. All patients were examined by an ophthalmologist at the time of diagnosis and, if present, ocular involvement was identified.</p><p><strong>Results: </strong>Among 78 pediatric patients, ocular involvement was present in 17 of 78 patients (21.8%). The most common ocular manifestation was retinal hemorrhage (16.7%). Ocular involvement was more frequent in acute myeloid leukemia (AML) than in acute lymphoblastic leukemia (ALL) (46.7% vs. 15.9%, p= 0.016). Older age (for ocular involvement: median 13 years [6-15] vs. 5 years [3-11], p = 0.006; for retinal hemorrhage: median 14 years [10-15] vs. 5 years [3-11], p = 0.001) and lower hemoglobin (for ocular involvement: 6.68 ± 2.31 g/dL vs. 8.46 ± 2.47 g/dL, p = 0.01; for retinal hemorrhage: 6.33 ± 2.26 g/dL vs. 8.43 ± 2.46 g/dL, p= 0.006) were associated with a higher risk. In multivariate models, age and Hb were independent predictors of hemorrhage (age: odds ratio [OR] 1.29, 95% confidence interval [CI] 1.10-1.52 per year; Hb: OR 0.60, 95% CI 0.38-0.95 per g/dL). ROC analyses showed that age provided the best discrimination (area under the curve [AUC] 0.796; 95% CI 0.651-0.940; cut-off ≥10 years: 73% sensitivity, 70% specificity), followed by Hb (AUC 0.756; 95% CI 0.604-0.908; cut-off 6.95 g/dL: sensitivity 76%, specificity 76%), whereas PLT showed weaker discrimination (AUC 0.682; 95% CI 0.553-0.812; cut-off 48,000/mm³: sensitivity 62%, specificity 65%).</p><p><strong>Conclusion: </strong>Approximately one in five children had ocular involvement at diagnosis, most commonly retinal hemorrhage. Age and hemoglobin independently predicted retinal hemorrhage and provided useful discrimination. These data support a \"hemoglobin-first\" triage that prioritizes initial and follow-up ocular fundus testing in older children and those with an Hb ≲7 g/dL, with external validation of the proposed thresholds warranted.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"68 3","pages":"450-460"},"PeriodicalIF":0.0,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of psychosocial adjustment in siblings of children with autism spectrum disorder: a structural equation modeling study.","authors":"Gökçen İlçioğlu Ekici, Birim Günay Kılıç","doi":"10.24953/turkjpediatr.2026.7288","DOIUrl":"10.24953/turkjpediatr.2026.7288","url":null,"abstract":"<p><strong>Background: </strong>Siblings of children with autism spectrum disorder (ASD) are at increased risk of psychosocial difficulties due to altered family dynamics and parental stress. However, the mechanisms linking ASD severity, parental psychopathology, and sibling outcomes remain unclear. This study aimed to identify determinants of psychosocial problems among siblings of children with ASD using a family-systems framework and structural equation modeling (SEM).</p><p><strong>Methods: </strong>A case-control study was conducted with 67 siblings of children with ASD (ASD-Sibs) and 67 siblings of typically developing children (TD-Sibs), aged 6-18 years. ASD severity was rated using the Childhood Autism Rating Scale (CARS). Sibling depression, anxiety, and emotion regulation were assessed using the Child Depression Inventory (CDI), Screen for Child Anxiety Related Emotional Disorders (SCARED), and Cognitive Emotion Regulation Questionnaire (CERQ). Parents completed the Child Behavior Checklist (CBCL), Beck Depression and Anxiety Inventories (BDI, BAI), and Family Assessment Device (FAD). SEM was used to examine predictors of sibling psychosocial outcomes.</p><p><strong>Results: </strong>ASD-Sibs reported significantly higher depressive and anxiety symptoms than TD-Sibs. SEM revealed that maternal depression and general family functioning were significant predictors of sibling depression, anxiety, and behavioral problems. ASD severity indirectly influenced sibling outcomes through maternal depression and anxiety. Positive reappraisal emerged as a protective factor against anxiety.</p><p><strong>Conclusions: </strong>Maternal psychological well-being and family functioning are key determinants of psychosocial adjustment among ASD-Sibs. Autism severity affects siblings indirectly via maternal psychopathology, underscoring the importance of holistic, family-centered interventions to promote resilience in families of children with ASD.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"68 2","pages":"297-312"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of rheumatologic diseases on pediatric inflammatory bowel disease.","authors":"Duygu Demirtaş Güner, Erdal Sağ, Hayriye Hızarcıoğlu Gülşen, Zeynep Balık, İnci Nur Saltık Temizel, Hasan Özen, Hülya Demir, Seza Özen","doi":"10.24953/turkjpediatr.2026.6631","DOIUrl":"10.24953/turkjpediatr.2026.6631","url":null,"abstract":"<p><strong>Background: </strong>The coexistence of rheumatologic diseases (RD) and inflammatory bowel disease (IBD) in children remains underexplored. This study aimed to assess the frequency of RD and its clinical impact in pediatric IBD patients.</p><p><strong>Methods: </strong>This retrospective cohort study included pediatric IBD patients followed at the Department of Pediatric Gastroenterology, Hepatology and Nutrition at Hacettepe University, Ankara, Türkiye between November 2008 and December 2020. Demographic characteristics, disease activity scores, inflammatory markers, and treatment modalities were compared between patients with and without concomitant RD; an additional analysis was performed in the familial Mediterranean fever (FMF) subgroup.</p><p><strong>Results: </strong>A total of 88 patients (35 females, 53 males; median age 14.6 years) were analyzed. RD was identified in 28 patients (31.8%), with FMF being the most frequent (19/28, 67.9%; overall 21.6%). Although patients with RD had lower disease activity at diagnosis (p = 0.010), they required more frequent biologic therapy during follow-up (35.7% vs. 16.7%, p = 0.047). In the FMF subgroup, disease activity scores were significantly lower at diagnosis and higher at the last follow-up compared with patients without RD. There were no significant differences in inflammatory markers between the groups at diagnosis and last follow-up.</p><p><strong>Conclusions: </strong>RD, particularly FMF, is commonly observed in pediatric IBD, with a prevalence of 31.8% for RD and 21.6% for FMF. The presence of RD is associated with an increased need for biologic therapy despite lower initial disease activity. Children with IBD should be systematically evaluated for RD, especially in regions with high MEFV mutation prevalence, to support more personalized management strategies.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"68 2","pages":"288-296"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting maternal perception and objective nutritional status in children with reported poor appetite.","authors":"Jayanth S Rajaram, Suresh Panchanathan","doi":"10.24953/turkjpediatr.2026.7503","DOIUrl":"10.24953/turkjpediatr.2026.7503","url":null,"abstract":"","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"68 2","pages":"364-365"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on dynamic plasma biomarker trajectories in pediatric sepsis.","authors":"Mehmet Çeleğen","doi":"10.24953/turkjpediatr.2026.8138","DOIUrl":"10.24953/turkjpediatr.2026.8138","url":null,"abstract":"","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"68 2","pages":"366-367"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasal polyps in childhood: insights from a pediatric pulmonology cohort.","authors":"Handan Kekeç, Tuğba Şişmanlar Eyüboğlu, Ali Buğra Çetinkaya, Nilgün Kula, Fatma Bozdağ, Ayşe Tana Aslan","doi":"10.24953/turkjpediatr.2026.7007","DOIUrl":"10.24953/turkjpediatr.2026.7007","url":null,"abstract":"<p><strong>Introduction: </strong>Nasal polyps (NP) are benign inflammatory growths originating from the nasal/paranasal sinus mucosa. NPs can occur independently or signify underlying respiratory conditions. This study aimed to evaluate the demographic and clinical characteristics of NPs in children at a pediatric pulmonology department.</p><p><strong>Method: </strong>This cross-sectional study included children aged 0-18 years diagnosed with NP at the pediatric pulmonology department from 2007 to 2025. Patients were categorized into four groups: cystic fibrosis (CF), primary ciliary dyskinesia (PCD), asthma/allergic rhinitis (AR), and undefined etiology. Demographic and clinical data were compared across these groups.</p><p><strong>Results: </strong>A total of 47 (40.4% female) patients were included in the study. The median age of NP diagnosis was 11 years (4.6-17.8). The most common presenting symptoms were nasal obstruction (47, 100%) and mouth breathing during sleep (37, 78.7%). The etiological causes of NPs were PCD (13, 27.7%), CF (9, 19.1%), asthma/AR (11, 23.4%), and an undefined etiology (14, 29.8%). Bilateral NPs were present in 32 (68.1%) cases. In 27 (57.4%) patients, NP was the first presentation, with no other symptoms. Among all PCD patients, NP was the first presentation in 7 (53.8%) of cases. NP recurrence was documented in 14 patients (29.8%). No significant differences were observed among the groups in sex, growth z-scores, or age at NP diagnosis (p>0.05). Bilateral NPs were more common in the PCD group (92.3%) than in the CF (66.7%), asthma/AR (36.3%), and undefined groups (71.4%) (p=0.034). NP recurrence was more frequent in the CF group (66.7%) compared with the PCD (38.5%) and undefined groups (13.6%), while no recurrence was observed in the asthma/AR group (p=0.021).</p><p><strong>Conclusion: </strong>This study highlights the heterogeneity of pediatric NP in causes, presentation, and course. Patients with PCD often present bilaterally, while CF patients have the highest recurrence rate. In PCD, NP was the initial sign in over half of cases, suggesting isolated NP should prompt suspicion of PCD.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"68 2","pages":"277-287"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrical cardiometry and lung ultrasound in detection of volume overload in pediatric patients on hemodialysis.","authors":"Sara Mabrouk Elghoul, Hala Ibrahim Hantash, Hebatallah A Bedair, Saad Ahmed Moharam, Mohammed Said Elsharkawy, Yomna Gaber Hassan Elfeky","doi":"10.24953/turkjpediatr.2026.5873","DOIUrl":"10.24953/turkjpediatr.2026.5873","url":null,"abstract":"<p><strong>Background: </strong>Assessment of volume overload and determination of dry weight are essential for children on hemodialysis (HD). This study aimed to compare the effectiveness of lung ultrasound (LUS)-derived B-lines and electrical cardiometry (EC)-derived thoracic fluid content (TFC) scores in detecting volume overload in pediatric patients undergoing maintenance HD.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on 50 patients aged 5 to 18 years, both sexes, with kidney failure on maintenance HD three times weekly. Dry weight was determined for each patient by a pediatric nephrologist based on a clinical assessment of hydration status (absence of edema, pulmonary rales, hypertension, intradialytic hypotension or cramps) and supported by bioimpedance spectroscopy values to estimate overhydration. Patients who did not reach dry weight at the end of the session were defined as the non-dry weight group (N=21) and those who did were defined as the dry weight (N=29) groups. Correlations of B-lines and TFC with clinical parameters and the diagnostic performance of these methods in predicting hypervolemia (ROC analysis) were analyzed.</p><p><strong>Results: </strong>Before dialysis, TFC and B-line scores did not differ significantly between the dry-weight and non-dry-weight groups (P>0.05), but were significantly lower after the HD session in the dry weight group than in the non-dry weight group (P < 0.001). TFC and B-line scores could significantly predict hypervolemia (areas under the curve [AUC]: 0.750 and 0.801, respectively). In the same order the cut off values were >31 kOhm⁻¹ and >17, sensitivities were 76.19% and 80.95%, and specificities were 55.71% and 75.86%, respectively. TFC was comparable to the B-line score in the prediction of hypervolemia (P=0.585, difference between AUCs=0.050; 95% confidence interval: -0.132 to 0.234).</p><p><strong>Conclusions: </strong>Both LUS and EC are valuable bedside methods for assessing volume overload in pediatric HD patients. However, EC is not as dependent on operator skills and may be a valuable tool in clinical practice, especially in settings where LUS might be challenging to perform.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"68 2","pages":"235-246"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution toward ovarian-sparing surgery in pediatric ovarian tumors: a 20-year single-center experience.","authors":"Özlem Balcı, İbrahim Karaman, Beytullah Yağız, Gürses Şahin, Özcan Bolat, Ayşe Karaman","doi":"10.24953/turkjpediatr.2026.7681","DOIUrl":"10.24953/turkjpediatr.2026.7681","url":null,"abstract":"<p><strong>Background: </strong>Ovarian tumors are rare in children, accounting for 1-2% of all pediatric malignancies. Recent trends emphasize fertility preservation, but data on the evolution of practice and outcomes remain limited. This study examines changes in surgical management and outcomes of pediatric ovarian tumors over two decades.</p><p><strong>Methods: </strong>All children who underwent surgery for ovarian pathologies at a tertiary pediatric surgery center between 2002 and 2021 were reviewed. Patients with histopathologically confirmed ovarian tumors were included. Clinical characteristics, surgical approaches, histopathology, and outcomes were analyzed. Patients were divided into two 10-year periods to evaluate trends over time, and age-based subgroup analysis compared prepubertal (≤12 years) and pubertal (≤12 years) patients.</p><p><strong>Results: </strong>Of 324 children undergoing ovarian surgery, 87 had histologically confirmed tumors. The most common histological type was mature cystic teratoma (54.0%). Eighteen tumors (20.7%) were malignant. Ovarian-sparing surgery (OSS) increased from 20.0% (6/30) to 61.4% (35/57) (p<0.001), and the laparoscopic approach increased from 6.7% to 35.1% (p=0.008). Patients undergoing OSS had significantly smaller tumors (median 7.0 cm vs 12.0 cm, p<0.001) and lower malignancy rates (2.4% vs 37.0%, p<0.001). Prepubertal patients had higher malignancy rates than pubertal patients (29.5% vs 11.6%, p=0.039). During a mean 4-year follow-up, recurrence rates were similar between OSS and oophorectomy groups (4.9% vs 2.2%, p=0.90).</p><p><strong>Conclusions: </strong>Surgical management of pediatric ovarian tumors has evolved significantly toward fertility-preserving approaches. OSS is safe and effective in appropriately selected patients. The higher malignancy rate in prepubertal patients highlights the importance of age-specific evaluation. Careful preoperative assessment and case selection remain essential for optimal outcomes.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"68 2","pages":"313-323"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive phenotypic characterization of <i>Pseudomonas aeruginosa</i> isolates from cystic fibrosis patients: antimicrobial susceptibility, tolerance, hypermutation, biofilm formation, and antibiofilm activity.","authors":"Öznur Gürpınar Tosun, Didem Kart, Beste Özsezen, Elmas Ebru Yalçın, Nagehan Emiralioğlu, Deniz Doğru Ersöz, Uğur Özçelik, Özgen Köseoğlu Eser","doi":"10.24953/turkjpediatr.2026.6794","DOIUrl":"10.24953/turkjpediatr.2026.6794","url":null,"abstract":"<p><strong>Background: </strong>Pseudomonas aeruginosa is an opportunistic pathogen that plays a critical role in chronic lung infections in patients with cystic fibrosis (CF), primarily due to its ability to form biofilms and develop antibiotic resistance. This study aimed to evaluate the biofilm-forming ability and antibiotic resistance profiles of P. aeruginosa isolates obtained from patients with CF, and to investigate the relationship between biofilm production and antimicrobial resistance.</p><p><strong>Methods: </strong>151 P. aeruginosa isolates were collected from patients with CF attending a university hospital. Antibiotic susceptibility testing was performed using both broth microdilution and gradient diffusion methods. Phenotypic determination of virulence factors was performed using standard plate assays. Biofilm production was quantified using the crystal violet microtiter plate assay and Minimum Biofilm Eradication Concentration (MBEC) assay. Statistical analysis was performed to evaluate the association between biofilm formation and antibiotic resistance.</p><p><strong>Results: </strong>The median age of patients with CF was 11.5 years, with 51.7% being female. Although resistance to certain antibiotics was observed, overall resistance rates remained relatively low, with the highest rate being 11%. A total of 30 (19.9%) P. aeruginosa isolates, showing intra-zone growth, were positive for antibiotic tolerance, while 10 (6.6%) of the 151 isolates exhibited hypermutator phenotypes based on the phenotypic hypermutation test. Biofilm evaluation showed that 14% of isolates were strong biofilm producers, 35.8% moderate, and 21.9% weak. 75 P. aeruginosa isolates were assessed for antibiofilm activity using the MBEC assay. Diallyl disulfide alone showed no significant effect. Combined with ciprofloxacin, it reduced minimum biofilm inhibitory concentration (MBIC) in 16% of isolates, while 28% showed increased MBIC, suggesting antagonism. With tobramycin, 22.3% of isolates showed enhanced antibiofilm activity, indicated by a decrease in MBIC.</p><p><strong>Conclusion: </strong>In our study, while a high level of biofilm production was observed among P. aeruginosa isolates from patients with CF, antibiotic resistance rates were found to be low. These results highlight the need for therapeutic strategies targeting biofilms to improve treatment outcomes in CF-related P. aeruginosa infections. Additionally, our data indicate that low ceftazidime resistance in this cohort supports the use of beta-lactam-based empirical strategies and carbapenem-sparing approaches, while recognizing that these findings may not be directly generalizable beyond the local context.</p>","PeriodicalId":101314,"journal":{"name":"The Turkish journal of pediatrics","volume":"68 2","pages":"247-260"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148008322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}