Turkish archives of pediatrics最新文献

{"title":"Extended-Spectrum Beta-Lactamase Positivity in Infants with Febrile Urinary Tract Infection: Risk Factors, Pathogen Distribution, and Temporal Trends.","authors":"Serap Ata, Sevgi Akova","doi":"10.65717/TurkArchPediatr.2026.25556","DOIUrl":"10.65717/TurkArchPediatr.2026.25556","url":null,"abstract":"<p><strong>Objective: </strong>To identify the risk factors for extended-spectrum beta-lactamase (ESBL) positivity in infants aged 1-12 months with febrile urinary tract infection (UTI), compare pathogen distribution and antibiotic resistance by ESBL status, and assess year-based changes in ESBL positivity from January 2018 and January 2025.</p><p><strong>Materials and methods: </strong>This retrospective, single-center study evaluated 321 infants (1-12 months) with first febrile UTI, comparing ESBL-positive and ESBL-negative isolates and analyzing temporal trends in ESBL positivity, pathogens, and empirical antibiotic use.</p><p><strong>Results: </strong>The overall ESBL positivity rate was 57.3%. The ESBL positivity was significantly associated with urinary tract anomalies (P < .001), antibiotic exposure within the preceding 3 months (P = .003), and prophylactic antibiotic use (P = .013) on urine dipstick testing (P = .001). Pathogen distribution differed significantly between ESBL-positive and ESBL-negative groups (P < .001). Although Escherichia coli was the most common pathogen in both groups, its frequency was lower in the ESBL-positive group compared with the ESBL-negative group (57.07% vs. 79.56%), whereas Klebsiella pneumoniae and Enterobacter cloacae were significantly more frequent among ESBL-positive isolates. The ESBL-positive isolates demonstrated significantly higher resistance rates to beta-lactams, fluoroquinolones, and trimethoprim-sulfamethoxazole (all P < .001). Temporal analyses revealed significant year-to-year variation in ESBL positivity (P < .001), peaking in 2023 (90.48%). Over time, the frequency of E. coli decreased, while K. pneumoniae increased.</p><p><strong>Conclusion: </strong>Urinary tract anomalies and prior antibiotic exposure are major risk factors for ESBL-positive febrile UTI in infants. The increasing contribution of K. pneumoniae and high resistance to commonly used empirical antibiotics underscore the need to reassess empirical treatment strategies in this vulnerable population.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 4","pages":"326-335"},"PeriodicalIF":1.7,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791611","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":"The Clinical and Molecular Spectrum of Turkish Patients with Syndromic Craniosynostosis: A Single Center Study.","authors":"Hilal Onur, Dilek Uludağ Alkaya, Ali Metin Kafadar, Burak Tahmazoğlu, Ayça Aykut, Yağmur Aydın, Nilay Güneş, Beyhan Tüysüz","doi":"10.65717/TurkArchPediatr.2026.25408","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.25408","url":null,"abstract":"<p><strong>Objective: </strong>Syndromic craniosynostosis is caused by pathogenic variants in genes regulating suture development. This study aims to investigate clinical and molecular characteristics in syndromic craniosynostosis.</p><p><strong>Materials and methods: </strong>This retrospective descriptive study included 53 patients from 40 families with syndromic craniosynostosis. Molecular testing was performed in 22 families.</p><p><strong>Results: </strong>The study included Saethre-Chotzen (n=14), Apert (n=12), Crouzon (n=11), Pfeiffer (n=4), Muenke (n=4), and Carpenter (n=1) syndromes, Crouzon syndrome with acanthosis nigricans (n=2), craniosynostosis with dental anomalies (n=2), craniosynostosis type 4 (n=2), and hypochondroplasia with craniosynostosis (n=1). Genetic etiology was identified in 20 families involving six genes: FGFR1 (Pfeiffer), FGFR2 (Apert, Crouzon, Pfeiffer), FGFR3 (Crouzon with acanthosis nigricans, Muenke), TWIST1 (Saethre-Chotzen), ERF (Craniosynostosis type 4), and IL11RA (Craniosynostosis with dental anomaly). Additionally, a FGFR3 variant causing hypochondroplasia was identified in a patient with multisuture synostosis. Familial inheritance was identified in 25%, but not in Apert syndrome. Brachycephaly (28.3%) was the most common cranial abnormality, followed by plagiocephaly (22.6%). Apert syndrome was characterized by frequent cardiac anomalies, cleft palate, developmental delay, and a higher rate of surgical intervention. In contrast, Crouzon, Pfeiffer, Saethre-Chotzen, and Muenke syndromes showed favorable outcomes, although a fatal course was observed in a patient with Crouzon syndrome with acanthosis nigricans. Rare etiologies included ERF-related craniosynostosis with mild craniofacial findings and IL11RA-related craniosynostosis with intrafamilial phenotypic heterogeneity.</p><p><strong>Conclusion: </strong>This study describes clinical features of well-defined syndromes such as Apert, Crouzon, and Pfeiffer; reports craniosynostosis in hypochondroplasia; and documents rare ERF- and IL11RA-related forms, highlighting the importance of combining clinical and molecular diagnostics.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 5","pages":"420-430"},"PeriodicalIF":1.7,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847442","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":"Isolated and Syndromic Talipes Equinovarus in Children: Differences in Clinical Presentation and Quality of Life.","authors":"Ulkar Huseyinova, Muhammed Doğukan Kalenderoğlu, Ece Eker, Göksel Vatansever, Hatice Mutlu","doi":"10.65717/TurkArchPediatr.2026.25314","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.25314","url":null,"abstract":"<p><strong>Objective: </strong>Talipes equinovarus (TEV) is a congenital foot deformity that can present either in an isolated form or as part of a syndromic condition. In syndromic TEV, dysmorphic features, systemic anomalies, and developmental delay are more frequently observed. This study aims to evaluate the differences in clinical characteristics, dysmorphic findings, and quality of life between isolated and syndromic forms of TEV in children.</p><p><strong>Materials and methods: </strong>Ninety TEV patients (37 syndromic, 53 isolated) diagnosed between 2010 and 2022 were included. Demographic and clinical data were retrospectively reviewed. Additional anomalies and dysmorphic features were prospectively assessed. Quality of life in children aged ≥2 years and their caregivers was evaluated using the Pediatric Quality of Life Inventory (PedsQL).</p><p><strong>Results: </strong>Consanguinity, low birth weight and developmental delay were significantly more frequent in the syndromic TEV group (P=.005, P=.014, P=.014), with central nervous system anomalies being the most common. The PedsQL scores were highest in controls, followed by isolated TEV, and lowest in syndromic TEV (P < .001, P < .001). Quality of life was negatively correlated with dysmorphic feature count (P < .001).</p><p><strong>Conclusion: </strong>Quality of life in children with syndromic TEV is significantly affected by physical and psychosocial factors. Syndromic TEV is associated with a more complex clinical course and lower quality of life compared to the isolated form. Early diagnosis, clinical genetic evaluation, multidisciplinary management, and psychosocial support may enhance treatment success and quality of life.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 4","pages":"312-319"},"PeriodicalIF":1.7,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791694","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":"Investigation of Serum Krebs von den Lungen-6 Level in Patients with Bone Sarcoma and Lung Metastasis.","authors":"Turan Bayhan, Selma Çakmakci, Nazan Çiledağ, Yasin Köksal, Seda Şahin, İnci Ergürhan İlhan, Neriman Sari","doi":"10.65717/TurkArchPediatr.2026.25309","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.25309","url":null,"abstract":"<p><strong>Objective: </strong>Serum Krebs von den Lungen-6 (KL-6) level increases in interstitial lung disease and lung cancer. The present study investigated whether there was an increase in serum KL-6 levels in patients with bone sarcoma who were considered positive for lung metastasis.</p><p><strong>Materials and methods: </strong>Serum samples were collected from patients diagnosed with Ewing sarcoma and osteosarcoma before starting chemotherapy. The samples were frozen and stored at -80°C, and serum KL-6 level was measured using enzyme-linked immunosorbent assay.</p><p><strong>Results: </strong>Serum samples of 47 patients and 42 healthy volunteers were evaluated. At the time of diagnosis, 10 patients had pulmonary tumor metastasis. Patients were followed up for a median of 43 months (1-125 months). At the time of diagnosis, the median KL-6 level of patients with lung metastases was 38.15 U/mL (10.6-155.6 U/mL), while the KL-6 level of patients without lung metastases was 15.2 U/mL (10.7-188.3 U/mL). The difference between these 2 groups was borderline significant (P = .051). The median KL-6 value of the control group was 14.85 U/mL (10.3-188.6 U/mL). When the patients with lung metastasis at the time of diagnosis were compared with the healthy control group, the KL-6 level of the patients was statistically significantly higher than the control group (P = .017).</p><p><strong>Conclusion: </strong>In this pilot study, it was found that serum KL-6 levels were elevated in patients with lung metastasis at the time of diagnosis compared to healthy controls. Serum KL-6 level may be used as an additional parameter to detect pulmonary metastasis, and further studies are needed to confirm this observation.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 5","pages":"438-443"},"PeriodicalIF":1.7,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847430","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":"The Association Between Maternal Depressive Symptoms and Postpartum Attachment in a Sample of Predominantly Highly Educated Mothers: A Secondary Analysis of a Cross-sectional Study.","authors":"Elif Öztürk, Betül Şenyürek, Öznur Gökçe Nizam, Ayşe Şahin, Melike Dönmez, Mahmut Caner Us, Hatice Ezgi Barış, Perran Boran","doi":"10.65717/TurkArchPediatr.2026.25168","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.25168","url":null,"abstract":"<p><strong>Objective: </strong>Postpartum attachment is a multidimensional construct influenced by maternal and infant-related factors. This study aimed to investigate factors associated with maternal-infant attachment (MIA), with a particular focus on maternal depressive symptoms and maternal self-efficacy (MSE).</p><p><strong>Materials and methods: </strong>This study represents a secondary analysis of data obtained from Turkish validity and reliability studies of the MSE Scale and the Maternal Postpartum Attachment Scale. Participants were mothers who completed these assessments via social media platforms. Maternal depressive symptom levels were assessed using the Patient Health Questionnaire-9. Factors associated with MIA were examined using correlation analyses and multiple linear regression models.</p><p><strong>Results: </strong>Data from 64 mothers who completed both surveys were evaluated. The infants' ages ranged from 1 to 12 months, with a median age of 6 (3-10) months. Among the participants, 90.6% had at least a university degree. Maternal attachment was positively correlated with MSE (P < .001, rs = 0.46) and negatively correlated with maternal depressive symptoms (P < .001, rs = -0.41). Attachment scores did not vary according to the number of children, education level, or maternal employment status. In the multiple regression model (adjusted R2 = 0.28, F (2,61) = 13.772, P < .001), both depressive symptom levels and maternal self-efficacy were significant predictors of MIA.</p><p><strong>Conclusion: </strong>This study demonstrates a negative association between maternal depressive symptoms and postpartum attachment in this cross-sectional sample. Future research should explore additional confounding variables and focus on holistic peripartum interventions to improve maternal-infant outcomes.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 6","pages":"487-494"},"PeriodicalIF":1.7,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152547","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":"Is the Hematologic Inflammatory Index Useful for Detecting Acute Appendicitis in Pediatric Patients?","authors":"Taner Aşkın, Tülin Öztaş, Nilüfer Okur, Muhammet Asena","doi":"10.65717/TurkArchPediatr.2026.25398","DOIUrl":"10.65717/TurkArchPediatr.2026.25398","url":null,"abstract":"<p><strong>Objective: </strong>Appendicitis represents the most frequent cause of emergency abdominal surgery in children. Early and precise recognition is essential to prevent complications and improve clinical outcomes. The research aimed to investigate the diagnostic performance of Hematologic Inflammatory Index (HII) in children suspected of appendicitis, while also evaluating its contribution to surgical decision-making.</p><p><strong>Materials and methods: </strong>A total of 349 patients (aged 5-18 years) admitted with abdominal pain were evaluated. Patients were categorized into 2 groups: cases with histopathologically confirmed acute appendicitis (AA, n=132) and cases with non-acute appendicitis (non-AA, n=217). Laboratory variables, such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and HII were recorded. Hematologic Inflammatory Index was calculated as: HII = platelet / (neutrophil × lymphocyte) × 100. Receiver-operating characteristic analysis was used to assess the diagnostic accuracy of HII.</p><p><strong>Results: </strong>Children in the AA group exhibited significantly higher white blood cells, neutrophil count, C-reactive protein, NLR, PLR, and HII values, along with lower lymphocyte and platelet counts, compared with the non-AA group (P < .05). For predicting AA, HII demonstrated a sensitivity of 78% and specificity of 62% at a cutoff value of >0.86.</p><p><strong>Conclusion: </strong>Although HII values were higher in pediatric appendicitis cases, the index did not demonstrate sufficient accuracy to serve as a reliable standalone diagnostic tool or to meaningfully guide surgical decision-making.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 6","pages":"508-513"},"PeriodicalIF":2.3,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152557","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":"Cerebral, Ocular, Dental, Auricular, and Skeletal Anomalies Syndrome in 3 Children: Clinical and Radiological Clues.","authors":"Dilek Uludağ Alkaya, Nilay Güneş, Ayşegül Bursalı, Ali Şeker, Ceyhun Arıcı, Beyhan Tüysüz","doi":"10.65717/TurkArchPediatr.2026.25385","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.25385","url":null,"abstract":"","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 8","pages":"748-751"},"PeriodicalIF":2.3,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655418","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":"Pediatric Quality of Life Inventory™ Eosinophilic Esophagitis Module: Evaluating Validity and Reliability in Turkish Children and Their Parents.","authors":"Hacer Ilbilge Ertoy Karagol, Dilek Yapar, Sinem Polat Terece, Hakan Ozturk, Demet Teker Duztas, Odul Egritas Gurkan, Sinan Sari, Mustafa Necmi İlhan, Buket Dalgic, Arzu Bakirtas","doi":"10.65717/TurkArchPediatr.2026.25321","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.25321","url":null,"abstract":"<p><strong>Objective: </strong>The Pediatric Quality of Life Inventory™ (PedsQL™) Eosinophilic Esophagitis (EoE) Module is a specialized instrument designed to assess how EoE affects the quality of life in pediatric patients. This study assesses the Turkish cross-cultural adaptation of the 8-12-year-old version.</p><p><strong>Materials and methods: </strong>As part of the cross-cultural adaptation of the Turkish PedsQL™ EoE Module for children aged 8-12 (Tr-PedsQL™ EoE), linguistic validation, content validity (CnV), construct validity (CsV), and reliability testing were conducted. The CsV was evaluated by correlating Tr-PEESS v2.0 Frequency and Total scores with the Tr-PedsQL™ EoE Symptoms Total, Symptoms I, and Symptoms II scores. Reliability was assessed using Cronbach's alpha for internal consistency and intraclass correlation coefficients (ICC) for test-retest stability.</p><p><strong>Results: </strong>The study included 25 children diagnosed with EoE and their parents (n=25). All items showed CnV indexes above 0.8. Good to excellent correlations (r=-0.459 to -0.948) between Tr-PEESS v2.0 (Frequency, Total) and Tr-PedsQL™ EoE Module (Total, Symptoms Total, Symptoms I-II) scores indicate CV. The 8-12-year-old version showed good to excellent internal consistency, with Cronbach's α values of 0.712-0.918 for children and 0.703-0.901 for parents. All ICCs indicated good to excellent test-retest reliability (0.777-0.905 for children, 0.801-0.941 for parents).</p><p><strong>Conclusion: </strong>Validity and reliability analyses confirmed that the Tr-PedsQL™ EoE Module is a psychometrically sound instrument for use in both children and their parents. It completed the cross-cultural adaptation process and is appropriate for implementation in both clinical practice and research contexts in Türkiye.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 4","pages":"344-351"},"PeriodicalIF":1.7,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791729","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":"Diagnosing Intestinal Tuberculosis and Crohn's Disease in Children in a tuberculosis endemic Country: A Daunting Challenge.","authors":"Nadira Musabbir, Fahmida Begum, Wahiduzzaman Mazumder","doi":"10.65717/TurkArchPediatr.2026.25340","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.25340","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the clinical, laboratory, endoscopic, and histological features of children with intestinal tuberculosis (ITB) and Crohn's disease (CD).</p><p><strong>Materials and methods: </strong>This single-center retrospective study was done among children with ITB and CD between January 2021 and December 2023. Their baseline demographics, clinical, laboratory, endoscopic, and histological findings were compared.</p><p><strong>Results: </strong>This study included 28 ITB and 21 CD patients. The prevalence of fever (57.1% vs. 14.3%; P=.003), subacute intestinal obstruction (21.4% vs. 0%; P=.031), and positive contact history (25% vs. 0%; P=.015) was more common in ITB patients, whereas nocturnal stooling (33.3% vs. 0%; P=.001), growth failure (66.7% vs. 35.7%; P=.032), extraintestinal manifestation (28.6% vs. 3.6%; P=.033), perianal involvement (33.3% vs. 7.1%; P=.028) predominated in CD patients with longer disease duration (7.3 ± 3.3 months vs. 5.1 ± 4.02 months; P=.003). Higher mean fecal calprotectin level (1145.45 ± 660.45 vs. 566.22 ± 299.18 ug/g; P=.002), left-sided colonic involvement with linear ulcer (42.9% vs. 7.1%; P=.005), aphthous ulcer (38.1% vs. 7.1%; P=.012), skip lesion (28.6% vs. 0%; P=.004), cobble-stoning (19% vs. 0%; P=.028), perianal lesion (33.3% vs. 7.1%; P=.028), and focally enhanced colitis (47.6% vs. 0%; P=.000) were more common in CD patients than ITB patients.</p><p><strong>Conclusion: </strong>A combination of clinical features, laboratory tests, and endoscopic evaluation is needed to accurately distinguish CD from ITB in children.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 6","pages":"502-507"},"PeriodicalIF":1.7,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152472","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":"Is It Possible to Foresee the Risk Factors for Carbapenem-Resistant Gram-Negative Bacterial Colonization in Newborns?","authors":"İlksen Yalcinoglu, Aslı Memisoglu, Gülsen Gelmez Altınkanat, Pınar Ay, Eda Kepenekli, Hülya Özdemir, Hülya Selva Bilgen, Eren Ozek","doi":"10.65717/TurkArchPediatr.2026.25221","DOIUrl":"https://doi.org/10.65717/TurkArchPediatr.2026.25221","url":null,"abstract":"<p><strong>Objective: </strong>Carbapenem-resistant gram-negative bacteria (CR-GNB) have become a critical concern in neonatal intensive care units (NICUs) due to limited therapeutic options, high morbidity, and mortality. Early identification of modifiable risk factors for rectal colonization is essential to guide infection control and preventive strategies. This study aimed to determine the risk factors associated with CR-GNB rectal colonization in hospitalized infants and to define the prevalence, clinical impact, and temporal trends of colonization in a tertiary NICU.</p><p><strong>Materials and methods: </strong>A total of 112 infants with rectal CR-GNB colonization and 113 non-colonized infants were retrospectively evaluated between January 2017 and 2020. Colonized patients were identified through routine weekly rectal swab surveillance initiated within the first 24 hours of NICU admission. Controls were matched for gestational age and approximate date of birth and received similar NICU care, although unmeasured factors related to caregivers and environment may exist. Demographic, perinatal, clinical, microbiological, and treatment data were retrospectively collected. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors.</p><p><strong>Results: </strong>Colonization was significantly associated with male sex, prolonged hospitalization, mechanical ventilation, perinatal hypoxia, colostomy, intraventricular hemorrhage, bronchopulmonary dysplasia, indwelling catheters, total parenteral nutrition, Orogastric (OG) tube, colostomy, antibiotic exposure, and formula feeding. Healthcare-associated infections were more common in the colonized group. Multivariate analysis identified OG tube, male sex, and antibiotic use as independent risk factors.</p><p><strong>Conclusion: </strong>Identifying and addressing modifiable factors such as orogastric tube use, broad spectrum antibiotic exposure, and formula feeding should be prioritized in preventive NICU protocols to reduce CR-GNB colonization. Recognition of these risk factors and careful monitoring of infection indicators may improve neonatal outcomes.</p>","PeriodicalId":75267,"journal":{"name":"Turkish archives of pediatrics","volume":"61 4","pages":"304-311"},"PeriodicalIF":1.7,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791748","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}