1
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Ligero-López J, Escosa-García L, Schüffelmann-Gutiérrez C, Laplaza-González M, Quiles-Melero MI, Moreno-Ramos F, Baquero-Artigao F, Cacho-Calvo J, Cendejas-Bueno E. Is it in their eyes? Correlation between microorganisms isolated from bronchial aspirates and conjunctival swabs in a Pediatric Intensive Care Unit. Rev Esp Quimioter 2024; 37:176-179. [PMID: 38258553 PMCID: PMC10945105 DOI: 10.37201/req/116.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024]
Abstract
OBJECTIVE Our observational, retrospective study aimed to determine the correlation between bacteria isolated from bronchial aspirates of pediatric ICU patients (PICU) with respiratory infections and those obtained from conjunctival swabs of the same patients exhibiting clinical conjunctivitis. METHODS Throughout the period from 2015 to 2022, we reviewed all clinically significant bronchial aspirates (≥105 CFU/mL) and positive conjunctival swabs obtained from PICU patients. These records were retrieved from the microbiology database, cross-referencing the data to identify patients who tested positive for both during the same clinical episode. RESULTS The median age of the patients was 5 months (interquartile range: 1-7). Among the cohort, twenty-one patients exhibited positivity in both bronchial aspirate and conjunctival swab samples, showcasing a microbial match in 85.71% of cases (18 out of 21). The most frequently isolated microorganisms were Haemophilus influenzae (55.6%), followed by Pseudomonas aeruginosa (14.3%), Klebsiella aerogenes (9.5%), and Escherichia coli, Stenotrophomonas maltophilia, and Enterobacter cloacae, each accounting for 4.8% of the isolates. CONCLUSIONS Our study demonstrates a strong concordance between the isolated microorganisms from both samples in patients presenting clear symptoms of clinical conjunctivitis. These findings provide a basis for future prospective studies that may leverage conjunctival swabs as a predictive tool for identifying microorganisms involved in respiratory infections.
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Affiliation(s)
| | | | | | | | | | | | | | | | - E Cendejas-Bueno
- Emilio Cendejas-Bueno, Clinical Microbiology Department, Hospital Universitario La Paz, Madrid, Spain, Paseo de La Castellana 261, 28046 Madrid, Spain.
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2
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Rodríguez-Molino P, González Sánchez A, Noguera-Julián A, Soler-García A, Martínez Paz P, Méndez-Echevarría A, Baquero-Artigao F, González Muñoz M, Ruíz-Serrano MJ, Monsonís M, Sánchez León R, Saavedra-Lozano J, Santiago-García B, Sainz T. QuantiFERON-TB reversion in children and adolescents with tuberculosis. Front Immunol 2024; 15:1310472. [PMID: 38576621 PMCID: PMC10991797 DOI: 10.3389/fimmu.2024.1310472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/28/2024] [Indexed: 04/06/2024] Open
Abstract
We analyzed 136 children with tuberculosis disease or infection and a positive QuantiFERON-TB (QFT) assay, followed-up for a median of 21 months (0.4-11years). QFT reversed in 16.9% of cases, with significant decreases in TB1 (-1.72 vs. -0.03 IU/ml, p=0.001) and TB2 (-1.65 vs. -0.43 IU/ml, p=0.005) levels compared to non-reverters. We found a higher QFT reversion rate among children under 5 years (25.0% vs 11.9%, p=0.042), and those with TST induration <15mm (29% vs 13.3%, p=0.055). Our data reveal that, although QFT test remained positive in the majority of children, reversion occurred in 16% of cases in a progressive and stable pattern. Younger age and reduced TST induration were associated with QFT reversion.
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Affiliation(s)
- Paula Rodríguez-Molino
- General Pediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain
- La Paz Research Institute (IdiPAZ), Madrid, Spain
- Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | | | - Antoni Noguera-Julián
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Servei de Malalties Infeccioses Patologia Importada, Institut de Recerca Pediàtrica Sant Joan de Déu, Barcelona, Spain
- Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Red de Investigación Translacional en Infectología Pediátrica (RITIP), Madrid, Spain
| | - Aleix Soler-García
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Servei de Malalties Infeccioses Patologia Importada, Institut de Recerca Pediàtrica Sant Joan de Déu, Barcelona, Spain
| | - Patricia Martínez Paz
- General Pediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain
| | - Ana Méndez-Echevarría
- General Pediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain
- La Paz Research Institute (IdiPAZ), Madrid, Spain
- Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Fernando Baquero-Artigao
- General Pediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain
- La Paz Research Institute (IdiPAZ), Madrid, Spain
- Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | | | - María Jesús Ruíz-Serrano
- Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañon, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Respiratorias - CIBERES, Madrid, Spain
| | - Manuel Monsonís
- Servei de Microbiologia, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Rocío Sánchez León
- General Pediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Jesús Saavedra-Lozano
- Infectious Diseases Department, General Pediatrics, Hospital Gregorio Marañón, Madrid, Spain
| | - Begoña Santiago-García
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Infectious Diseases Department, General Pediatrics, Hospital Gregorio Marañón, Madrid, Spain
| | - Talía Sainz
- General Pediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain
- La Paz Research Institute (IdiPAZ), Madrid, Spain
- Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Red de Investigación Translacional en Infectología Pediátrica (RITIP), Madrid, Spain
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3
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Ríos-Barnés M, Velasco-Arnaiz E, Fortuny C, Benavides M, Baquero-Artigao F, Muga O, Del Valle R, Frick MA, Bringué X, Herrero S, Vilas J, Alonso-Ojembarrena A, Castells-Vilella L, Rojo P, Blázquez-Gamero D, Esteva C, Sánchez E, Alarcón A, Noguera-Julian A. Renal Function Impairment in Children With Congenital Cytomegalovirus Infection: A Cross-sectional Study. Pediatr Infect Dis J 2024; 43:257-262. [PMID: 38063508 DOI: 10.1097/inf.0000000000004176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
BACKGROUND We aimed to determine the prevalence and severity of glomerular and tubular renal dysfunction by means of urinalysis in infants and toddlers with congenital cytomegalovirus infection (cCMV) and their association with cCMV disease, viruria and antiviral treatment. METHODS This cross-sectional study was done using the Spanish Registry of Congenital Cytomegalovirus Infection. First-morning urine samples were collected from January 2016 to December 2018 from patients <5 years old enrolled in Spanish Registry of Congenital Cytomegalovirus Infection. Samples were excluded in case of fever or other signs or symptoms consistent with acute infection, bacteriuria or bacterial growth in urine culture. Urinary protein/creatinine and albumin/creatinine ratios, urinary beta-2-microglobulin levels, hematuria and CMV viruria were determined. A 0.4 cutoff in the urinary albumin/protein ratio was used to define tubular (<0.4) or glomerular (>0.4) proteinuria. Signs and symptoms of cCMV at birth, the use of antivirals and cCMV-associated sequelae at last available follow-up were obtained from Spanish Registry of Congenital Cytomegalovirus Infection. RESULTS Seventy-seven patients (37 females, 48.1%; median [interquartile range] age: 14.0 [4.4-36.2] months) were included. Symptom-free elevated urinary protein/creatinine and albumin/creatinine ratios were observed in 37.5% and 41.9% of patients, respectively, with tubular proteinuria prevailing (88.3%) over glomerular proteinuria (11.6%). Proteinuria in the nephrotic range was not observed in any patients. In multivariate analysis, female gender was the only risk factor for tubular proteinuria (adjusted odds ratio = 3.339, 95% confidence interval: 1.086-10.268; P = 0.035). cCMV disease at birth, long-term sequelae, viruria or the use of antivirals were not associated with urinalysis findings. CONCLUSIONS Mild nonsymptomatic tubular proteinuria affects approximately 40% of infants and toddlers with mostly symptomatic cCMV in the first 5 years of life.
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Affiliation(s)
- María Ríos-Barnés
- From the Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Pediatric Infectious Diseases Department, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Eneritz Velasco-Arnaiz
- From the Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Pediatric Infectious Diseases Department, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Clàudia Fortuny
- From the Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Pediatric Infectious Diseases Department, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Centre for Biomedical Network Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP)
| | - Marta Benavides
- Pediatric Infectious Diseases Unit, Hospital Universitario La Paz
| | - Fernando Baquero-Artigao
- Pediatric Infectious Diseases Unit, Hospital Universitario La Paz
- La Paz Research Institute (IdiPAZ), Universidad Autónoma de Madrid (UAM)
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Oihana Muga
- Department of Pediatrics, Hospital de Donostia, San Sebastián, Spain
| | - Rut Del Valle
- Department of Pediatrics, Hospital Infanta Sofía, Madrid, Spain
| | - Marie Antoinette Frick
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Spain
| | - Xavier Bringué
- Department of Pediatrics and Neonatal Unit, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - Susana Herrero
- Department of Pediatrics, Hospital Sant Llàtzer, Palma de Mallorca, Spain
| | - Javier Vilas
- Department of Pediatrics, Hospital de Pontevedra, Pontevedra, Spain
| | - Almudena Alonso-Ojembarrena
- Neonatal Intensive Care Unit, Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Hospital Puerta del Mar, Cádiz, Spain
| | - Laura Castells-Vilella
- Department of Pediatrics and Neonatal Unit, Hospital General de Cataluña, Barcelona, Spain
| | - Pablo Rojo
- Pediatric Infectious Diseases Unit, Hospital Universitario 12 de Octubre, Universidad Complutense, Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Daniel Blázquez-Gamero
- Pediatric Infectious Diseases Unit, Hospital Universitario 12 de Octubre, Universidad Complutense, Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Cristina Esteva
- Centre for Biomedical Network Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Molecular Microbiology Unit, Hospital Universitari Sant Joan de Déu
| | | | - Ana Alarcón
- Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Department of Neonatology, Hospital Sant Joan de Déu, Neonatal Brain Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Antoni Noguera-Julian
- From the Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Pediatric Infectious Diseases Department, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Centre for Biomedical Network Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP)
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4
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Villar-Hernández R, Latorre I, Noguera-Julian A, Martínez-Planas A, Minguell L, Vallmanya T, Méndez M, Soriano-Arandes A, Baquero-Artigao F, Rodríguez-Molino P, Guillén-Martín S, Toro-Rueda C, De Souza-Galvão ML, Jiménez-Fuentes MÁ, Stojanovic Z, Sabriá J, Santos JR, Puig J, Domínguez-Álvarez M, Millet JP, Altet N, Galea Y, Muriel-Moreno B, García-García E, Bach-Griera M, Prat-Aymerich C, Julián E, Torrelles JB, Rodrigo C, Domínguez J. Development and Evaluation of an NTM-IGRA to Guide Pediatric Lymphadenitis Diagnosis. Pediatr Infect Dis J 2024; 43:278-285. [PMID: 38113520 DOI: 10.1097/inf.0000000000004211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND Diagnosis of nontuberculous mycobacteria (NTM) infections remains a challenge. In this study, we describe the evaluation of an immunological NTM-interferon (IFN)-γ release assay (IGRA) that we developed using glycopeptidolipids (GPLs) as NTM-specific antigens. METHODS We tested the NTM-IGRA in 99 samples from pediatric patients. Seventy-five were patients with lymphadenitis: 25 were NTM confirmed, 45 were of unknown etiology but compatible with mycobacterial infection and 5 had lymphadenitis caused by an etiologic agent other than NTM. The remaining 24 samples were from control individuals without lymphadenitis (latently infected with M. tuberculosis , uninfected controls and active tuberculosis patients). Peripheral blood mononuclear cells were stimulated overnight with GPLs. Detection of IFN-γ producing cells was evaluated by enzyme-linked immunospot assay. RESULTS NTM culture-confirmed lymphadenitis patient samples had a significantly higher response to GPLs than the patients with lymphadenitis of unknown etiology but compatible with mycobacterial infection ( P < 0.001) and lymphadenitis not caused by NTM ( P < 0.01). We analyzed the response against GPLs in samples from unknown etiology lymphadenitis but compatible with mycobacterial infection cases according to the tuberculin skin test (TST) response, and although not statistically significant, those with a TST ≥5 mm had a higher response to GPLs when compared with the TST <5 mm group. CONCLUSIONS Stimulation with GPLs yielded promising results in detecting NTM infection in pediatric patients with lymphadenitis. Our results indicate that the test could be useful to guide the diagnosis of pediatric lymphadenitis. This new NTM-IGRA could improve the clinical handling of NTM-infected patients and avoid unnecessary misdiagnosis and treatments.
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Affiliation(s)
- Raquel Villar-Hernández
- From the Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Barcelona, Spain
- CIBER Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona, Barcelona, Spain
- R&D Department, Genome Identification Diagnostics (GenID) GmbH, Strassberg, Germany
| | - Irene Latorre
- From the Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Barcelona, Spain
- CIBER Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Antoni Noguera-Julian
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Servei de Malalties Infeccioses i Patologia Importada, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Red de Investigación Translacional en Infectología Pediátrica, RITIP, Madrid, Spain
- Departament de Cirurgia i Especialitats Medicoquirúrgiques, Universitat de Barcelona, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
| | - Aina Martínez-Planas
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Servei de Malalties Infeccioses i Patologia Importada, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Red de Investigación Translacional en Infectología Pediátrica, RITIP, Madrid, Spain
| | - Laura Minguell
- Department of Pediatrics, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Teresa Vallmanya
- Department of Pediatrics, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - María Méndez
- Servei de Pediatria, Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Institut d'Investigació Germans Trias i Pujol
| | - Antoni Soriano-Arandes
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Fernando Baquero-Artigao
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario de La Paz
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III
| | - Paula Rodríguez-Molino
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario de La Paz
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III
| | | | | | | | | | - Zoran Stojanovic
- CIBER Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Madrid, Spain
- Servei de Pneumologia, Hospital Universitari Germans Trias i Pujol
| | - Josefina Sabriá
- Servei de Pneumologia, Hospital Sant Joan Despí Moises Broggi, Sant Joan Despí, Barcelona, Spain
| | - José Ramón Santos
- Fundació Lluita contra les Infeccions, Servicio de Enfermedades Infecciosas, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Jordi Puig
- Fundació Lluita contra les Infeccions, Servicio de Enfermedades Infecciosas, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | - Joan-Pau Millet
- CIBER de Epidemiología y Salud Pública, CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
- Unidad Clínica de Tratamiento Directamente Observado "Serveis Clinics," Barcelona, Spain
| | - Neus Altet
- CIBER de Epidemiología y Salud Pública, CIBERESP, Instituto de Salud Carlos III, Madrid, Spain
- Unidad Clínica de Tratamiento Directamente Observado "Serveis Clinics," Barcelona, Spain
| | - Yolanda Galea
- Servei de Pneumologia, Hospital General de Granollers, Granollers, Spain
| | - Beatriz Muriel-Moreno
- From the Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Barcelona, Spain
- CIBER Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Esther García-García
- From the Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Barcelona, Spain
- CIBER Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marc Bach-Griera
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Prat-Aymerich
- From the Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Barcelona, Spain
- CIBER Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona, Barcelona, Spain
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Esther Julián
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi B Torrelles
- Population Health Program, Texas Biomedical Research Institute, San Antonio, Texas
| | - Carlos Rodrigo
- Servei de Pediatria, Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Institut d'Investigació Germans Trias i Pujol
| | - José Domínguez
- From the Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Barcelona, Spain
- CIBER Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona, Barcelona, Spain
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5
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del Rosal T, Bote-Gascón P, Falces-Romero I, Sainz T, Baquero-Artigao F, Rodríguez-Molino P, Méndez-Echevarría A, Bravo-Queipo-de-Llano B, Alonso LA, Calvo C. Multiplex PCR and Antibiotic Use in Children with Community-Acquired Pneumonia. Children (Basel) 2024; 11:245. [PMID: 38397359 PMCID: PMC10887858 DOI: 10.3390/children11020245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/08/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Abstract
Antibiotics are frequently prescribed to children with pneumonia, although viruses are responsible for most cases. We aimed to evaluate the impact of multiplex polymerase chain reaction (mPCR) on antibiotic use. We conducted a prospective study of children under 14 years of age admitted for suspected viral pneumonia, from October 2019 to June 2022 (except March-November 2020). A mPCR respiratory panel (FilmArray® 2plus, bioMérieux, Marcy-l'Étoile, France) was performed within 72 h of admission. Patients with positive reverse transcription PCR for respiratory syncytial virus, influenza, or SARS-CoV-2 were excluded. We compared the patients with historical controls (2017-2018) who had suspected viral pneumonia but did not undergo an aetiological study. We included 64 patients and 50 controls, with a median age of 26 months. The respiratory panel detected viral pathogens in 55 patients (88%), including 17 (31%) with co-infections. Rhinovirus/enterovirus (n = 26) and human metapneumovirus (n = 22) were the most common pathogens, followed by adenovirus and parainfluenza (n = 10). There were no statistically significant differences in the total antibiotic consumption (83% of cases and 86% of controls) or antibiotics given for ≥72 h (58% vs. 66%). Antibiotics were prescribed in 41% of the cases and 72% of the controls at discharge (p = 0.001). Ampicillin was the most commonly prescribed antibiotic among the patients (44% vs. 18% for controls, p = 0.004), while azithromycin was the most commonly prescribed among the controls (19% vs. 48% for patients and controls, respectively; p = 0.001). Our findings underscore the need for additional interventions alongside molecular diagnosis to reduce antibiotic usage in paediatric community-acquired pneumonia.
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Affiliation(s)
- Teresa del Rosal
- Pediatrics and Infectious Diseases Department, Institute for Health Research IdiPAZ, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain; (P.B.-G.); (T.S.); (F.B.-A.); (P.R.-M.); (A.M.-E.); (L.A.A.); (C.C.)
- Translational Research Network in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER U767, Instituto de Salud Carlos III), 28029 Madrid, Spain
| | - Patricia Bote-Gascón
- Pediatrics and Infectious Diseases Department, Institute for Health Research IdiPAZ, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain; (P.B.-G.); (T.S.); (F.B.-A.); (P.R.-M.); (A.M.-E.); (L.A.A.); (C.C.)
- Translational Research Network in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Pediatric Emergency Department, Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Iker Falces-Romero
- Microbiology Department, Hospital Universitario La Paz, 28046 Madrid, Spain;
- Center for Biomedical Network Research on Infectious Diseases (CIBERINFEC, Instituto de Salud Carlos III), 28029 Madrid, Spain
| | - Talía Sainz
- Pediatrics and Infectious Diseases Department, Institute for Health Research IdiPAZ, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain; (P.B.-G.); (T.S.); (F.B.-A.); (P.R.-M.); (A.M.-E.); (L.A.A.); (C.C.)
- Translational Research Network in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Center for Biomedical Network Research on Infectious Diseases (CIBERINFEC, Instituto de Salud Carlos III), 28029 Madrid, Spain
- Department of Pediatrics, Faculty of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
| | - Fernando Baquero-Artigao
- Pediatrics and Infectious Diseases Department, Institute for Health Research IdiPAZ, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain; (P.B.-G.); (T.S.); (F.B.-A.); (P.R.-M.); (A.M.-E.); (L.A.A.); (C.C.)
- Translational Research Network in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Center for Biomedical Network Research on Infectious Diseases (CIBERINFEC, Instituto de Salud Carlos III), 28029 Madrid, Spain
| | - Paula Rodríguez-Molino
- Pediatrics and Infectious Diseases Department, Institute for Health Research IdiPAZ, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain; (P.B.-G.); (T.S.); (F.B.-A.); (P.R.-M.); (A.M.-E.); (L.A.A.); (C.C.)
- Translational Research Network in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Center for Biomedical Network Research on Infectious Diseases (CIBERINFEC, Instituto de Salud Carlos III), 28029 Madrid, Spain
| | - Ana Méndez-Echevarría
- Pediatrics and Infectious Diseases Department, Institute for Health Research IdiPAZ, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain; (P.B.-G.); (T.S.); (F.B.-A.); (P.R.-M.); (A.M.-E.); (L.A.A.); (C.C.)
- Translational Research Network in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Center for Biomedical Network Research on Infectious Diseases (CIBERINFEC, Instituto de Salud Carlos III), 28029 Madrid, Spain
- Department of Pediatrics, Faculty of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
| | - Blanca Bravo-Queipo-de-Llano
- Pediatrics and Infectious Diseases Department, Institute for Health Research IdiPAZ, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain; (P.B.-G.); (T.S.); (F.B.-A.); (P.R.-M.); (A.M.-E.); (L.A.A.); (C.C.)
- Translational Research Network in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
| | - Luis A. Alonso
- Pediatrics and Infectious Diseases Department, Institute for Health Research IdiPAZ, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain; (P.B.-G.); (T.S.); (F.B.-A.); (P.R.-M.); (A.M.-E.); (L.A.A.); (C.C.)
- Translational Research Network in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
| | - Cristina Calvo
- Pediatrics and Infectious Diseases Department, Institute for Health Research IdiPAZ, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain; (P.B.-G.); (T.S.); (F.B.-A.); (P.R.-M.); (A.M.-E.); (L.A.A.); (C.C.)
- Translational Research Network in Pediatric Infectious Diseases (RITIP), 28046 Madrid, Spain
- Center for Biomedical Network Research on Infectious Diseases (CIBERINFEC, Instituto de Salud Carlos III), 28029 Madrid, Spain
- Department of Pediatrics, Faculty of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
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Guarch-Ibáñez B, Carreras-Abad C, Frick MA, Blázquez-Gamero D, Baquero-Artigao F, Fuentes-Corripio I, Soler-Palacin P. Results of the REIV-TOXO national survey on prenatal screening for toxoplasmosis in Spain. Enferm Infecc Microbiol Clin (Engl Ed) 2024:S2529-993X(24)00011-X. [PMID: 38296670 DOI: 10.1016/j.eimce.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/21/2023] [Accepted: 08/02/2023] [Indexed: 02/02/2024]
Abstract
INTRODUCTION Currently, the status of serological screening for toxoplasmosis in pregnant women in Spain is unknown, and there is no official recommendation. The objective of this study is to show the current practice of gestational screening for toxoplasmosis in hospitals belonging to the Spanish Network for Research on Congenital Toxoplasmosis (REIV-TOXO). METHODS An electronic survey was sent between April 2021 and September 2021 to investigators from 118 hospitals of REIV-TOXO, representing all Spanish regions. Nine items related to gestational screening for toxoplasmosis were collected. This information was compared with cases of congenital toxoplasmosis (CT) identified in REIV-TOXO to determine if these were diagnosed in the presence of gestational screening. RESULTS During the study period, serological screening was performed in 53.3% (63/118) hospitals, with variations between regions and even among hospitals within the same region. Testing performed in each trimester was the most common practice (57.7%), followed by a single determination (24.4%). 89.4% of CT cases between January 2015 and September 2021 were diagnosed due to gestational screening. CONCLUSION The decision to perform gestational screening for toxoplasmosis in Spain is highly heterogeneous, with significant local and regional differences. Despite this, screening still allows the diagnosis of most CT cases. It is urgent to have current epidemiological data to inform decision-making in public health.
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Affiliation(s)
- Borja Guarch-Ibáñez
- Unidad de Infectología pediátrica ICS-IAS de Girona, Servicio de Pediatría, Hospital Universitari Dr. Josep Trueta; Universitat de Girona, Girona, Spain.
| | - Clara Carreras-Abad
- Unidad de Infectología Pediátrica, Servicio de Pediatría, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Maria Antoinette Frick
- Unidad de Patología Infecciosa e Immunodeficiencias de Pediatría, Hospital Infantil Vall d'Hebron, Barcelona Hospital Campus, Barcelona, Catalunya, España; Vall d'Hebron Research Institute, Barcelona, Spain; Grupo de Trabajo de Infecciones Congénitas, Sociedad Española de Infectología Pediátrica (SEIP), Spain
| | - Daniel Blázquez-Gamero
- Grupo de Trabajo de Infecciones Congénitas, Sociedad Española de Infectología Pediátrica (SEIP), Spain; Unidad de Infectología Pediátrica, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Fernando Baquero-Artigao
- Unidad de Infectología Pediátrica, Hospital La Paz; Universidad Autónoma de Madrid; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Fuentes-Corripio
- Unidad de Toxoplasmosis y protozoos intestinales, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Pere Soler-Palacin
- Unidad de Patología Infecciosa e Immunodeficiencias de Pediatría, Hospital Infantil Vall d'Hebron, Barcelona Hospital Campus, Barcelona, Catalunya, España; Vall d'Hebron Research Institute, Barcelona, Spain; Grupo de Trabajo de Infecciones Congénitas, Sociedad Española de Infectología Pediátrica (SEIP), Spain
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7
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Sáez-Llorens X, Norero X, Mussi-Pinhata MM, Luciani K, de la Cueva IS, Díez-Domingo J, Lopez-Medina E, Epalza C, Brzostek J, Szymański H, Boucher FD, Cetin BS, De Leon T, Dinleyici EC, Gabriel MÁM, Ince T, Macias-Parra M, Langley JM, Martinón-Torres F, Rämet M, Kuchar E, Pinto J, Puthanakit T, Baquero-Artigao F, Gattinara GC, Arribas JMM, Ramos Amador JT, Szenborn L, Tapiero B, Anderson EJ, Campbell JD, Faust SN, Nikic V, Zhou Y, Pu W, Friel D, Dieussaert I, Lopez AG, McPhee R, Stoszek SK, Vanhoutte N. Safety and Immunogenicity of a ChAd155-Vectored Respiratory Syncytial Virus Vaccine in Infants 6-7 Months of age: A Phase 1/2 Randomized Trial. J Infect Dis 2024; 229:95-107. [PMID: 37477875 PMCID: PMC10786261 DOI: 10.1093/infdis/jiad271] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/16/2023] [Accepted: 07/20/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract infections in infants. This phase 1/2, observer-blind, randomized, controlled study assessed the safety and immunogenicity of an investigational chimpanzee-derived adenoviral vector RSV vaccine (ChAd155-RSV, expressing RSV F, N, and M2-1) in infants. METHODS Healthy 6- to 7-month-olds were 1:1:1-randomized to receive 1 low ChAd155-RSV dose (1.5 × 1010 viral particles) followed by placebo (RSV_1D); 2 high ChAd155-RSV doses (5 × 1010 viral particles) (RSV_2D); or active comparator vaccines/placebo (comparator) on days 1 and 31. Follow-up lasted approximately 2 years. RESULTS Two hundred one infants were vaccinated (RSV_1D: 65; RSV_2D: 71; comparator: 65); 159 were RSV-seronaive at baseline. Most solicited and unsolicited adverse events after ChAd155-RSV occurred at similar or lower rates than after active comparators. In infants who developed RSV infection, there was no evidence of vaccine-associated enhanced respiratory disease (VAERD). RSV-A neutralizing titers and RSV F-binding antibody concentrations were higher post-ChAd155-RSV than postcomparator at days 31, 61, and end of RSV season 1 (mean follow-up, 7 months). High-dose ChAd155-RSV induced stronger responses than low-dose, with further increases post-dose 2. CONCLUSIONS ChAd155-RSV administered to 6- to 7-month-olds had a reactogenicity/safety profile like other childhood vaccines, showed no evidence of VAERD, and induced a humoral immune response. Clinical Trials Registration. NCT03636906.
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Affiliation(s)
- Xavier Sáez-Llorens
- Department of Infectious Diseases, Hospital del Niño Dr. José Renán Esquivel
- Vaccine Research Department, Centro de Vacunación Internacional
- Sistema Nacional de Investigación
- Secretaria Nacional de Ciencia y Tecnologia, Panama City, Panama
| | - Ximena Norero
- Department of Infectious Diseases, Hospital del Niño Dr. José Renán Esquivel
- Vaccine Research Department, Centro de Vacunación Internacional
| | - Marisa Márcia Mussi-Pinhata
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Kathia Luciani
- Department of Infectious Diseases, Hospital de Especialidades Pediátricas Omar Torrijos Herrera, Caja de Seguro Social, Panama City, Panama
| | | | - Javier Díez-Domingo
- FISABIO Fundación para el Fomento Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Centro de Investigación Biomédica en Red of Epidemiology and Public Health, Valencia, Spain
| | - Eduardo Lopez-Medina
- Centro de Estudios en Infectología Pediátrica, Department of Pediatrics, Universidad del Valle, Clínica Imbanaco, Grupo Quironsalud, Cali, Colombia
| | - Cristina Epalza
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Research and Clinical Trials Unit, Instituto de Investigación Sanitaria Hospital 12 de Octubre, Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Jerzy Brzostek
- Oddział Dziecięcy, Zespół Opieki Zdrowotnej w Dębicy, Dębica
| | - Henryk Szymański
- Department of Pediatrics, St Hedwig of Silesia Hospital, Trzebnica, Poland
| | - François D Boucher
- Department of Pediatrics, Centre Hospitalier Universitaire de Québec, Université Laval, Québec, Canada
| | - Benhur S Cetin
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Tirza De Leon
- Department of Vaccines, Cevaxin Sede David, Chiriquí, Panama
| | - Ener Cagri Dinleyici
- Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Miguel Ángel Marín Gabriel
- Departamento de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Departamento de Pediatría, Universidad Autónoma de Madrid, Madrid, Spain
| | - Tolga Ince
- Department of Social Pediatrics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | | | - Joanne M Langley
- Canadian Center for Vaccinology, Dalhousie University, IWK Health and Nova Scotia Health, Halifax, Canada
| | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases Section, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela
- Vaccines, Infections and Pediatrics Research Group, Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela
- Centro de Investigación Biomédica en Red of Respiratory Diseases, Instituto de Salud Carlos III, Madrid, Spain
| | - Mika Rämet
- Vaccine Research Center, Tampere University, Tampere, Finland
| | - Ernest Kuchar
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Warsaw, Poland
| | - Jorge Pinto
- Department of Pediatrics, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Thanyawee Puthanakit
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Fernando Baquero-Artigao
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario Infantil La Paz, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, ISCIII, Madrid, Spain
| | - Guido Castelli Gattinara
- Centro Vaccinazioni, Dipartimento Pediatrico Universitario Ospedaliero, Istituti di Ricovero e Cura a Carattere Scientifico, Ospedale Pediatrico Bambino Gesù, Lazio, Rome, Italy
| | | | - Jose Tomas Ramos Amador
- Department of Pediatrics, Universidad Complutense–Instituto de Investigación Sanitaria del Hospital Clínico San Carlos
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain
| | - Leszek Szenborn
- Department of Pediatrics and Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Bruce Tapiero
- Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montreal, Canada
| | - Evan J Anderson
- Departments of Pediatrics and Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - James D Campbell
- Center for Vaccine Development and Global Health, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Saul N Faust
- National Institute for Health and Care Research Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton National Health Service Foundation Trust, and Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, United Kingdom
| | | | | | - Wenji Pu
- GSK, Biostatistics, Rockville, Maryland
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Hernanz-Lobo A, Noguera-Julian A, Minguell L, López-Suárez A, Soriano-Arandes A, Espiau M, Colino Gil E, López Medina EM, Bustillo-Alonso M, Aguirre-Pascual E, Baquero-Artigao F, Calavia Garsaball O, Gomez-Pastrana D, Falcón-Neyra L, Santiago-García B. Prevalence and Clinical Characteristics of Children With Nonsevere Tuberculosis in Spain. Pediatr Infect Dis J 2023; 42:837-843. [PMID: 37410579 DOI: 10.1097/inf.0000000000004016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
BACKGROUND To assess the prevalence and characteristics of nonsevere TB among children in Spain. It has been recently demonstrated that these children can be treated with a 4-month regimen instead of the classical 6-month treatment regimen, with the same effectivity and outcomes, decreasing toxicity and improving adherence. METHODS We conducted a retrospective cohort study in a cohort of children ≤16 years of age with TB. Nonsevere TB cases included smear-negative children with respiratory TB confined to 1 lobe, with no significant airway obstruction, no complex pleural effusion, no cavities and no signs of miliary disease, or with peripheral lymph-node disease. The remaining children were considered to have severe TB. We estimated the prevalence of nonsevere TB and compared the clinical characteristics and outcomes between children with nonsevere and severe TB. RESULTS A total of 780 patients were included [46.9% males, median age 5.5 years (IQR: 2.6-11.1)], 477 (61.1%) of whom had nonsevere TB. Nonsevere TB was less frequent in children <1 year (33% vs 67%; P < 0.001), and >14 years of age (35% vs 65%; P = 0.002), mostly diagnosed in contact tracing studies (60.4% vs 29.2%; P < 0.001) and more frequently asymptomatic (38.3% vs 17.7%; P < 0.001). TB confirmation in nonsevere disease was less frequent by culture (27.0% vs 57.1%; P < 0.001) and by molecular tests (18.2% vs 48.8%; P < 0.001). Sequelae were less frequent in children with nonsevere disease (1.7 vs 5.4%; P < 0.001). No child with nonsevere disease died. CONCLUSIONS Two-thirds of children had nonsevere TB, mostly with benign clinical presentation and negative microbiologic results. In low-burden countries, most children with TB might benefit from short-course regimens.
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Affiliation(s)
- Alicia Hernanz-Lobo
- From the Pediatric Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain
- Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- RITIP Translational Research Network in Pediatric Infectious Diseases, Madrid, Spain
| | - Antoni Noguera-Julian
- RITIP Translational Research Network in Pediatric Infectious Diseases, Madrid, Spain
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Hospital Sant Joan de Déu
- Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
- Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - Laura Minguell
- Department of Paediatrics, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Andrea López-Suárez
- Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Antoni Soriano-Arandes
- RITIP Translational Research Network in Pediatric Infectious Diseases, Madrid, Spain
- Pediatrics Department, Drassanes-Vall d'Hebron Center for International Health and Communicable Diseases, Barcelona, Spain
- Pediatric Infectious Diseases Unit, Complejo Hospitalario Insular Materno Infantil Las Palmas, Las Palmas de Gran Canaria, Spain
| | - Maria Espiau
- Pediatrics Department, Drassanes-Vall d'Hebron Center for International Health and Communicable Diseases, Barcelona, Spain
- Pediatric Infectious Diseases Unit, Complejo Hospitalario Insular Materno Infantil Las Palmas, Las Palmas de Gran Canaria, Spain
| | - Elena Colino Gil
- Pediatrics Department, Drassanes-Vall d'Hebron Center for International Health and Communicable Diseases, Barcelona, Spain
| | | | - Matilde Bustillo-Alonso
- Pediatrics Infectious Diseases Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Fernando Baquero-Artigao
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- RITIP Translational Research Network in Pediatric Infectious Diseases, Madrid, Spain
- Department of Infectious Diseases and Tropical Pediatrics, La Paz Hospital, Madrid, Spain
| | | | - David Gomez-Pastrana
- Unidad de Neumología Infantil, Servicio de Pediatría, Hospital Universitario Materno-Infantil de Jerez, Jerez de la Frontera, Spain
- Grupo de investigación UNAIR, Jerez de la Frontera, Cádiz, Spain
| | - Lola Falcón-Neyra
- RITIP Translational Research Network in Pediatric Infectious Diseases, Madrid, Spain
- Pediatric Infectious Diseases, Rheumatology and Immunology Unit, Hospital Universitario Virgen del Rocío, Institute of Biomedicine, Seville, Spain
| | - Begoña Santiago-García
- From the Pediatric Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain
- Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- RITIP Translational Research Network in Pediatric Infectious Diseases, Madrid, Spain
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Grasa C, Monteagudo-Vilavedra E, Pérez-Arenas E, Falces-Romero I, Mozo Del Castillo Y, Schüffelmann-Gutiérrez C, Del Rosal T, Méndez-Echevarría A, Baquero-Artigao F, Zarauza Santoveña A, Serrano Fernández P, Sainz T, Calvo C. Adenovirus Infection in Hematopoietic and Solid Organ Paediatric Transplant Recipients: Treatment, Outcomes, and Use of Cidofovir. Microorganisms 2023; 11:1750. [PMID: 37512922 PMCID: PMC10386416 DOI: 10.3390/microorganisms11071750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/20/2023] [Accepted: 07/01/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND human adenovirus (hAdV) infection constitutes an important cause of morbidity and mortality in transplant recipients, due to their immune status. Among drugs currently available, cidofovir (CDF) is the most prescribed. METHODS Retrospective study of hAdV infection in paediatric transplant recipients from a tertiary paediatric centre, describing characteristics, management, and outcomes, and focused on the role of CDF. RESULTS 49 episodes of infection by hAdV were detected during a four-year period: 38 episodes in patients that received allogeneic hematopoietic stem cell transplantation (77.6%) and 11 in solid organ transplant recipients (22.4%). Twenty-five patients (52.1%) were symptomatic, presenting mainly fever and/or diarrhoea. CDF was prescribed in 24 patients (49%), with modest results. CDF use was associated with the presence of symptoms resulting in lower lymphocyte count, paediatric intensive care unit admission, and high viral load. Other therapeutic measures included administration of intravenous immunoglobulin, reducing immunosuppression, and T-lymphocyte infusion. Despite treatment, 22.9% of patients did not resolve the infection and there were three deaths related to hAdV infection. All-cause mortality was 16.7% (8 episodes) by 30 days, and 32.7% (16 episodes) by 90 days, of which, 3 episodes (3/16, 18.8%) were attributed to hAdV directly. CONCLUSIONS hAdV infection had high morbidity and mortality in our series. CDF use is controversial, and available therapeutic options are limited. Transplant patients with low lymphocyte count are at higher risk of persistent positive viremias, and short-term survival of these patients was influenced by the resolution of hAdV infection.
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Affiliation(s)
- Carlos Grasa
- Pediatric Infectious Diseases Department, Instituto de Investigación Sanitaria del Hospital Universitario la Paz (IdiPAZ), Hospital Universitario la Paz, 28046 Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III-ISCIII, 28029 Madrid, Spain
| | | | - Elena Pérez-Arenas
- Pediatric Infectious Diseases Department, Instituto de Investigación Sanitaria del Hospital Universitario la Paz (IdiPAZ), Hospital Universitario la Paz, 28046 Madrid, Spain
| | - Iker Falces-Romero
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III-ISCIII, 28029 Madrid, Spain
- Microbiology Department, Instituto de Investigación Sanitaria del Hospital Universitario la Paz (IdiPAZ), Hospital Universitario la Paz, 28041 Madrid, Spain
| | - Yasmina Mozo Del Castillo
- Pediatric Hematology and Oncology Department, Instituto de Investigación Sanitaria del Hospital Universitario la Paz (IdiPAZ), Hospital Universitario la Paz, 28046 Madrid, Spain
| | - Cristina Schüffelmann-Gutiérrez
- Pediatric Intensive Care Department, Instituto de Investigación Sanitaria del Hospital Universitario la Paz (IdiPAZ), Hospital Universitario la Paz, 28046 Madrid, Spain
| | - Teresa Del Rosal
- Pediatric Infectious Diseases Department, Instituto de Investigación Sanitaria del Hospital Universitario la Paz (IdiPAZ), Hospital Universitario la Paz, 28046 Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Instituto de Salud Carlos III-ISCIII, 28029 Madrid, Spain
- Red de Investigación Traslacional en Infectología Pediátrica (RITIP), 28046 Madrid, Spain
| | - Ana Méndez-Echevarría
- Pediatric Infectious Diseases Department, Instituto de Investigación Sanitaria del Hospital Universitario la Paz (IdiPAZ), Hospital Universitario la Paz, 28046 Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III-ISCIII, 28029 Madrid, Spain
- Red de Investigación Traslacional en Infectología Pediátrica (RITIP), 28046 Madrid, Spain
- Medicine Faculty, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
| | - Fernando Baquero-Artigao
- Pediatric Infectious Diseases Department, Instituto de Investigación Sanitaria del Hospital Universitario la Paz (IdiPAZ), Hospital Universitario la Paz, 28046 Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III-ISCIII, 28029 Madrid, Spain
| | | | | | - Talía Sainz
- Pediatric Infectious Diseases Department, Instituto de Investigación Sanitaria del Hospital Universitario la Paz (IdiPAZ), Hospital Universitario la Paz, 28046 Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III-ISCIII, 28029 Madrid, Spain
- Red de Investigación Traslacional en Infectología Pediátrica (RITIP), 28046 Madrid, Spain
- Medicine Faculty, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
| | - Cristina Calvo
- Pediatric Infectious Diseases Department, Instituto de Investigación Sanitaria del Hospital Universitario la Paz (IdiPAZ), Hospital Universitario la Paz, 28046 Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III-ISCIII, 28029 Madrid, Spain
- Red de Investigación Traslacional en Infectología Pediátrica (RITIP), 28046 Madrid, Spain
- Medicine Faculty, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
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Rodríguez-Molino P, Sola IM, Del Álamo López JG, Baquero-Artigao F, Díaz-Almiron M, Moreno-Pérez D, Calvo C, Escosa-García L. Duration of antibiotic therapy among paediatricians: A national survey of current clinical practice in Spain. Int J Antimicrob Agents 2023; 62:106805. [PMID: 37019243 DOI: 10.1016/j.ijantimicag.2023.106805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/20/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVES Appropriate duration of antibiotic treatment is a key principle to reduce the emergence of bacterial resistance and antibiotic harm. The aim of this study was to document current clinical practice among Spanish paediatricians in terms of the duration of antibiotic therapy in both inpatient and outpatient settings, mapping the difference between practice and guidelines, and thus identifying opportunities to improve practice. METHODS A national exploratory work survey was distributed in 2020 as a questionnaire about seven main infectious syndromes in children: genitourinary; skin and soft tissue; osteoarticular; ear, nose and throat; pneumonia; central nervous system; and bacteraemia. The answers were contrasted with current recommendations regarding the duration of antibiotic therapy. Demographic analysis was also performed. RESULTS The survey was completed by 992 paediatricians in Spain, representing 9.5% of paediatricians working in the Spanish national health system. Hospital care clinicians accounted for 42.7% (6662/15590) of responses. The antibiotic duration used in practice was longer than recommended in 40.8% (6359/15590) of responses, and shorter than recommended in 16% (1705/10654) of responses. Only 25% (249/992) and 23% (229/992) of respondents indicated that they would prescribe antibiotics for the recommended treatment duration for lower urinary tract infection and community-acquired pneumonia (AI evidence). Among severe hospital-managed infections, a tendency towards longer courses of antibiotics was found for non-complicated meningococcal infections and non-complicated pneumococcal, Gram-negative and S. aureus bacteraemia. CONCLUSIONS A noteworthy tendency towards prescribing antibiotics for longer than recommended among paediatricians was evidenced in this nationwide study, highlighting a wide range of opportunities for potential improvement.
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Affiliation(s)
- Paula Rodríguez-Molino
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz y La Paz Research Institute, Madrid, Spain; Área de Enfermedades Infecciosas del Centro de Investigación Biomédica en Red del Instituto de Salud Carlos III, Instituto de Salud Carlos III, Madrid, Spain; Unidad de Investigación, La Paz Research Institute, Madrid, Spain; Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Isabel Mellado Sola
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz y La Paz Research Institute, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Spain; Unidad de Investigación, La Paz Research Institute, Madrid, Spain; Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Jaime Gutiérrez Del Álamo López
- Servicio de Pediatría, Infectología Pediátrica e Inmunodeficiencias, Hospital Regional Universitario de Málaga e IBIMA Multidisciplinary Group for Pediatric Research, Málaga University, Málaga, Spain
| | - Fernando Baquero-Artigao
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz y La Paz Research Institute, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Spain; Área de Enfermedades Infecciosas del Centro de Investigación Biomédica en Red del Instituto de Salud Carlos III, Instituto de Salud Carlos III, Madrid, Spain
| | | | - David Moreno-Pérez
- Red de Investigación Translacional en Infectología Pediátrica, Spain; Servicio de Pediatría, Infectología Pediátrica e Inmunodeficiencias, Hospital Regional Universitario de Málaga e IBIMA Multidisciplinary Group for Pediatric Research, Málaga University, Málaga, Spain
| | - Cristina Calvo
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz y La Paz Research Institute, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Spain; Área de Enfermedades Infecciosas del Centro de Investigación Biomédica en Red del Instituto de Salud Carlos III, Instituto de Salud Carlos III, Madrid, Spain; Unidad de Investigación, La Paz Research Institute, Madrid, Spain; Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Luis Escosa-García
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz y La Paz Research Institute, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Spain; Área de Enfermedades Infecciosas del Centro de Investigación Biomédica en Red del Instituto de Salud Carlos III, Instituto de Salud Carlos III, Madrid, Spain; Unidad de Investigación, La Paz Research Institute, Madrid, Spain.
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11
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Permuy C, Ruiz-Azcárate J, Sampedro M, Jiménez C, Baquero-Artigao F, Calvo C, Méndez-Echevarría A. Usefulness of daptomycin lock therapy in children with catheter-related bacteremia after failed vancomycin lock therapy. Ann Clin Microbiol Antimicrob 2023; 22:48. [PMID: 37349770 DOI: 10.1186/s12941-023-00604-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/16/2023] [Indexed: 06/24/2023] Open
Abstract
PURPOSE Catheter-related bacteremia (CRB) is a significant cause of morbidity, resource expenditure and prolonged hospital stays in patients with long-term catheters, whose numbers have increased considerably in recent years. Antibiotic lock therapy reaches high concentrations in the catheter, allowing good penetration into the biofilm, being vancomycin the most commonly used one in gram-positive infections. Several authors have recently reported the superior in vitro efficacy of daptomycin compared with vancomycin, especially for eradicating biofilms. Although there is some data on the use of daptomycin for antibiotic lock in animal models and adults, there are no data on its use in children. METHODS A descriptive study was conducted in a tertiary hospital, including patients younger than 16 years in whom daptomycin lock therapy was employed between 2018 and 2022. RESULTS We report three pediatric patients in whom CRB was confirmed on admission by paired blood cultures positive for CoNS sensitive to vancomycin, daptomycin and linezolid. All patients started vancomycin lock therapy and systemic antibiotic therapy with proven sensitivity for the isolated bacteria, without achieving negative blood cultures. Due to the persistence of positive cultures, vancomycin lock therapy was replaced by daptomycin, and blood cultures turned negative, with no relapses or need for catheter removal. CONCLUSION The use of daptomycin lock therapy could be considered in children with CoNS catheter infection, especially when other antibiotic lock therapy had failed.
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Affiliation(s)
- Celia Permuy
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz., Paseo de La Castellana 261, 28046, Madrid, Spain
| | - Jone Ruiz-Azcárate
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz., Paseo de La Castellana 261, 28046, Madrid, Spain
| | - Mercedes Sampedro
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz., Paseo de La Castellana 261, 28046, Madrid, Spain
| | - Cristina Jiménez
- Department of Pharmacology, Hospital Universitario La Paz, Madrid, Spain
| | - Fernando Baquero-Artigao
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz., Paseo de La Castellana 261, 28046, Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Institute for Health Research IdiPAZ. CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Calvo
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz., Paseo de La Castellana 261, 28046, Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Institute for Health Research IdiPAZ. CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Méndez-Echevarría
- Paediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz., Paseo de La Castellana 261, 28046, Madrid, Spain.
- Translational Research Network in Pediatric Infectious Diseases (RITIP), Institute for Health Research IdiPAZ. CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain.
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Pintado V, Ruiz-Garbajosa P, Aguilera-Alonso D, Baquero-Artigao F, Bou G, Cantón R, Grau S, Gutiérrez-Gutiérrez B, Larrosa N, Machuca I, Martínez Martínez L, Montero MM, Morte-Romea E, Oliver A, Paño-Pardo JR, Sorlí L. Executive summary of the consensus document of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) on the diagnosis and antimicrobial treatment of infections due to carbapenem-resistant Gram-negative bacteria. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:360-370. [PMID: 36522272 DOI: 10.1016/j.eimce.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 06/05/2023]
Abstract
Infections caused by multidrug resistant Gram-negative bacteria are becoming a worldwide problem due to their increasing incidence and associated high mortality. Carbapenem-resistant bacteria such as Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii are the most important in clinical practice. The objective of these guidelines is to update the recommendations for the diagnosis and treatment of infections caused by these multidrug resistant bacteria. Although 'old' antibiotics such as aminoglycosides, colistin, or tigecycline are frequently used for therapy of these bacteria, the 'new' beta-lactams such as ceftazidime-avibactam, ceftolozane-tazobactam, meropenem-vaborbactam, imipenem-cilastatin-relebactam or cefiderocol are progressively becoming the first-line therapy for most of these microorganisms. The Spanish Society of Infectious Diseases and Clinical Microbiology (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica) designated a panel of experts in the field to provide evidence-based recommendations in response to common clinical questions. This document is primarily focused on microbiological diagnosis, clinical management, and targeted antimicrobial therapy of these infections, with special attention to defining the role of the new antimicrobials in the treatment of these bacteria.
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Affiliation(s)
- Vicente Pintado
- Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal e Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER en Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid (CIBERINFEC), Madrid, Spain.
| | - Patricia Ruiz-Garbajosa
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal e IRYCIS, CIBERINFEC, Madrid, Spain
| | - David Aguilera-Alonso
- Unidad de Enfermedades Infecciosas Pediátricas, Servicio de Pediatría, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain; Sociedad Española de Infectología Pediátrica (SEIP), Red de Investigación Traslacional en Infectología Pediátrica (RITIP), CIBERINFEC, Spain
| | - Fernando Baquero-Artigao
- Unidad de Enfermedades Infecciosas Pediátricas, Servicio de Pediatría, Hospital La Paz, SEIP, RITIP y CIBERINFEC, Madrid, Spain
| | - Germán Bou
- Servicio de Microbiología, Complejo Hospitalario Universitario A Coruña, CIBERINFEC, A Coruña, Spain
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal e IRYCIS, CIBERINFEC, Madrid, Spain
| | - Santiago Grau
- Departamento de Farmacia, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain
| | - Belén Gutiérrez-Gutiérrez
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Departamento de Medicina, Universidad de Sevilla, Instituto de Biomedicina de Sevilla (IBiS), CIBERINFEC, Sevilla, Spain
| | - Nieves Larrosa
- Servicio de Microbiología, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca (VHIR), CIBERINFEC, Barcelona, Spain
| | - Isabel Machuca
- Unidad Clínica de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), CIBERINFEC, Córdoba, Spain
| | - Luis Martínez Martínez
- Unidad de Gestión Clínica de Microbiología, Hospital Universitario Reina Sofía, Departamento de Química Agrícola, Edafología y Microbiología, Universidad de Córdoba, IMIBIC, CIBERINFEC, Córdoba, Spain
| | - María Milagro Montero
- Universitat Pompeu Fabra, Barcelona, Spain; Servicio de Enfermedades Infecciosas, Hospital del Mar, Parc de Salut Mar, CIBERINFEC, Barcelona, Spain
| | - Elena Morte-Romea
- Servicio de Enfermedades Infecciosas, Hospital Clínico Universitario Lozano Blesa, Instituto de Investigación Sanitaria Aragón, CIBERINFEC, Zaragoza, Spain
| | - Antonio Oliver
- Servicio de Microbiología y Unidad de Investigación, Hospital Son Espases, CIBERINFEC, Palma de Mallorca, Spain
| | - José Ramón Paño-Pardo
- Servicio de Enfermedades Infecciosas, Hospital Clínico Universitario Lozano Blesa, Instituto de Investigación Sanitaria Aragón, CIBERINFEC, Zaragoza, Spain
| | - Luisa Sorlí
- Universitat Pompeu Fabra, Barcelona, Spain; Servicio de Enfermedades Infecciosas, Hospital del Mar, Parc de Salut Mar, CIBERINFEC, Barcelona, Spain
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Díez-Domingo J, Sáez-Llorens X, Rodriguez-Weber MA, Epalza C, Chatterjee A, Chiu CH, Lin CY, Berry AA, Martinón-Torres F, Baquero-Artigao F, Langley JM, Ramos Amador JT, Domachowske JB, Huang LM, Chiu NC, Esposito S, Moris P, Lien-Anh Nguyen T, Nikic V, Woo W, Zhou Y, Dieussaert I, Leach A, Gonzalez Lopez A, Vanhoutte N. Safety and Immunogenicity of a ChAd155-Vectored Respiratory Syncytial Virus (RSV) Vaccine in Healthy RSV-Seropositive Children 12-23 Months of Age. J Infect Dis 2023; 227:1293-1302. [PMID: 36484484 PMCID: PMC10226655 DOI: 10.1093/infdis/jiac481] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 12/08/2022] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Safe and effective respiratory syncytial virus (RSV) vaccines remain elusive. This was a phase I/II trial (NCT02927873) of ChAd155-RSV, an investigational chimpanzee adenovirus-RSV vaccine expressing 3 proteins (fusion, nucleoprotein, and M2-1), administered to 12-23-month-old RSV-seropositive children followed up for 2 years after vaccination. METHODS Children were randomized to receive 2 doses of ChAd155-RSV or placebo (at a 1:1 ratio) (days 1 and 31). Doses escalated from 0.5 × 1010 (low dose [LD]) to 1.5 × 1010 (medium dose [MD]) to 5 × 1010 (high dose [HD]) viral particles after safety assessment. Study end points included anti-RSV-A neutralizing antibody (Nab) titers through year 1 and safety through year 2. RESULTS Eighty-two participants were vaccinated, including 11, 14, and 18 in the RSV-LD, RSV-MD, and RSV-HD groups, respectively, and 39 in the placebo groups. Solicited adverse events were similar across groups, except for fever (more frequent with RSV-HD). Most fevers were mild (≤38.5°C). No vaccine-related serious adverse events or RSV-related hospitalizations were reported. There was a dose-dependent increase in RSV-A Nab titers in all groups after dose 1, without further increase after dose 2. RSV-A Nab titers remained higher than prevaccination levels at year 1. CONCLUSIONS Three ChAd155-RSV dosages were found to be well tolerated. A dose-dependent immune response was observed after dose 1, with no observed booster effect after dose 2. Further investigation of ChAd155-RSV in RSV-seronegative children is warranted. CLINICAL TRIALS REGISTRATION NCT02927873.
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Affiliation(s)
| | - Xavier Sáez-Llorens
- Department of Infectious Diseases, Hospital del Niño Dr José Renán Esquivel and Cevaxin Clinical Research Center, Panama City, Panama
- National Investigation System, Senacyt, Panama City, Panama
| | | | - Cristina Epalza
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain
- Research and Clinical Trials Unit, Madrid, Spain
- Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid, Spain
- RITIP (Traslational Research Network in Pediatric Infectious Diseases), Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Archana Chatterjee
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Cheng-Hsun Chiu
- Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University Taoyuan, Taoyuan, Taiwan
| | - Chien-Yu Lin
- Department of Pediatrics, Hsinchu Mackay Memorial Hospital, Hsinchu City, Taiwan
| | - Andrea A Berry
- Department of Pediatrics and Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases, Pediatrics Department, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
- Genetics, Vaccines, Infectious Diseases and Pediatrics Research Group, Spain, Instituto de Investigación Sanitaria de Santiago, Universidad de Santiago de Compostela, Galicia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Baquero-Artigao
- Hospital Universitario Infantil La Paz, Department of Infectious Diseases and Tropical Pediatrics, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Joanne M Langley
- Canadian Center for Vaccinology, Iwk Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Canada
| | - José T Ramos Amador
- Departamento De Salud Pública Y Materno-infantil, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Joseph B Domachowske
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Li-Min Huang
- Department of Pediatrics, National Taiwan University Hospital, Taipei City, Taiwan
| | - Nan-Chang Chiu
- Department of Pediatrics, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Susanna Esposito
- Pietro Barilla Children's Hospital, University of Parma, Pediatric Clinic, Parma, Italy
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Baquero-Artigao F, Del Rosal T, Falcón-Neyra L, Ferreras-Antolín L, Gómez-Pastrana D, Hernanz-Lobo A, Méndez-Echevarría A, Noguera-Julian A, Pascual Sánchez MT, Rodríguez-Molino P, Piñeiro-Pérez R, Santiago-García B, Soriano-Arandes A. Update on the diagnosis and treatment of tuberculosis. An Pediatr (Barc) 2023:S2341-2879(23)00108-4. [PMID: 37236883 DOI: 10.1016/j.anpede.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/22/2023] [Indexed: 05/28/2023] Open
Abstract
According to World Health Organization estimates, more than 1 million patients aged less than 15 years develop tuberculosis (TB) each year worldwide. In some regions, up to 25% of new TB cases are caused by drug-resistant strains. Although Spain is considered a low-incidence country, several hundred children and adolescents develop TB each year. The importance of paediatric TB has been minimized for years due to the lack of microbiological confirmation in many patients and because these patients are not usually contagious. Nevertheless, in the past 15 years there have been major improvements in the epidemiological reporting of TB in children and adolescents, new immunodiagnostic tests have been developed, molecular methods that allow rapid microbiological diagnosis and detection of variants associated with drug resistance have become available, novel second-line antituberculosis drugs have been discovered, including for paediatric use, and the results of clinical trials have validated shorter courses of treatment for some patients. This document, developed by a group of experts from the Sociedad Española de Infectología Pediátrica and the Sociedad Española de Neumología Pediátrica, updates and complements the previous guidelines for the diagnostic and therapeutic management of children with TB in Spain based on the newly available scientific evidence.
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Affiliation(s)
- Fernando Baquero-Artigao
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz, Madrid, Spain; Fundación IdiPAZ, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain
| | - Teresa Del Rosal
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz, Madrid, Spain; Fundación IdiPAZ, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Lola Falcón-Neyra
- Servicio de Infectología, Reumatología e Inmunología Pediátrica, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Laura Ferreras-Antolín
- Servicio de Infectología e Inmunología Pediátrica, St. George's University Hospital, NHS Foundation Trust, London, UK
| | - David Gómez-Pastrana
- Servicio de Pediatría, Hospital Universitario de Jerez, Grupo de Investigación UNAIR, Jerez de la Frontera, Cádiz, Spain
| | - Alicia Hernanz-Lobo
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Sección de Enfermedades Infecciosas Pediátricas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación en Salud Gregorio Marañón, Madrid, Spain
| | - Ana Méndez-Echevarría
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz, Madrid, Spain; Fundación IdiPAZ, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain
| | - Antoni Noguera-Julian
- Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain; Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain; Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Servei de Malalties Infeccioses i Patologia Importada, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.
| | | | - Paula Rodríguez-Molino
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz, Madrid, Spain; Fundación IdiPAZ, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain
| | - Roi Piñeiro-Pérez
- Servicio de Pediatría, Hospital Universitario General de Villalba, Collado-Villalba, Madrid, Spain
| | - Begoña Santiago-García
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Sección de Enfermedades Infecciosas Pediátricas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación en Salud Gregorio Marañón, Madrid, Spain
| | - Antoni Soriano-Arandes
- Unidad de Patología Infecciosa e Inmunodeficiencias Pediátricas, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Vall d'Hebron Institut de Recerca, Barcelona, Spain
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Cobo-Vázquez E, Aguilera-Alonso D, Carbayo T, Figueroa-Ospina LM, Sanz-Santaeufemia F, Baquero-Artigao F, Vázquez-Ordoñez C, Carrasco-Colom J, Blázquez-Gamero D, Jiménez-Montero B, Grasa-Lozano C, Cilleruelo MJ, Álvarez A, Comín-Cabrera C, Penin M, Cercenado E, Del Valle R, Roa MÁ, Diego IGD, Calvo C, Saavedra-Lozano J. Epidemiology and clinical features of Streptococcus pyogenes bloodstream infections in children in Madrid, Spain. Eur J Pediatr 2023:10.1007/s00431-023-04967-5. [PMID: 37140702 DOI: 10.1007/s00431-023-04967-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/24/2023] [Accepted: 03/31/2023] [Indexed: 05/05/2023]
Abstract
Studies have shown increased invasive Group A Streptococcus (GAS) disease, including bloodstream infections (GAS-BSI). However, the epidemiological data of GAS-BSI are limited in children. We aimed to describe GAS-BSI in children in Madrid, over 13 years (2005-2017). Multicenter retrospective cohort study from 16 hospitals from Madrid, Spain. Epidemiology, symptomatology, laboratory, treatment, and outcome of GAS-BSI in children ≤ 16 years were analyzed. 109 cases of GAS-BSI were included, with incidence rate of 4.3 episodes/100,000 children attended at the emergency department/year. We compared incidence between two periods (P1: 2005-June 2011 vs P2: July 2011-2017) and observed a non-significant increase along the study period (annual percentage change: + 6.0% [95%CI: -2.7, + 15.4]; p = 0.163). Median age was 24.1 months (IQR: 14.0-53.7), peaking during the first four years of life (89/109 cases; 81.6%). Primary BSI (46.8%), skin and soft tissue (21.1%), and osteoarticular infections (18.3%) were the most common syndromes. We compared children with primary BSI with those with a known source and observed that the former had shorter hospital stay (7 vs. 13 days; p = 0.003) and received intravenous antibiotics less frequently (72.5% vs. 94.8%; p = 0.001) and for shorter duration of total antibiotic therapy (10 vs. 21 days; p = 0.001). 22% of cases required PICU admission. Factors associated with severity were respiratory distress, pneumonia, thrombocytopenia, and surgery, but in multivariate analysis, only respiratory distress remained significant (adjusted OR:9.23 [95%CI: 2.16-29.41]). Two children (1.8%) died. Conclusion: We observed an increasing, although non-significant, trend of GAS-BSI incidence within the study. Younger children were more frequently involved, and primary BSI was the most common and less severe syndrome. PICU admission was frequent, being respiratory distress the main risk factor. What is known: • In recent decades, several reports have shown a worldwide increase in the incidence of invasive Group A streptococcal disease (GAS), including bloodstream infection (BSI). Recently, there have been a few reports showing an increase in severity as well. • There needs to be more information on the epidemiology in children since most studies predominantly include adults. What is new: • This study, carried out in children with GAS-BSI in Madrid, shows that GAS-BSI affects mostly younger children, with a broad spectrum of manifestations, needing PICU admission frequently. Respiratory distress was the leading risk factor for severity, whereas primary BSI seemed to be less severe. • We observed an increasing, although non-significant, trend of GAS-BSI incidence in recent years (2005-2017).
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Affiliation(s)
- Elvira Cobo-Vázquez
- Department of Pediatrics, Hospital Universitario Fundación de Alcorcón, Servicio de Pediatría, Calle Budapest Nº1, 28922, Alcorcón, Madrid, Spain
- PhD Program in Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - David Aguilera-Alonso
- PhD Program in Medicine, Universidad Complutense de Madrid, Madrid, Spain.
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital General Universitario Gregorio Marañón. CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Servicio de Pediatría, Calle de O'Donnell, Madrid, 28009, Madrid, Spain.
| | - Tania Carbayo
- Department of Neonatology, Hospital Universitario, 12 de Octubre, Madrid, Spain
| | | | | | - Fernando Baquero-Artigao
- Department of Infectious Diseases and Tropical Pediatrics, Hospital Universitario La Paz and IdiPaz Foundation, Madrid, Spain
- RITIP, Translational Research Network in Pediatric Infectious Diseases, CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Universidad Autónoma, Madrid, Spain
| | | | - Jaime Carrasco-Colom
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario La Moraleja, Madrid, Spain
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Daniel Blázquez-Gamero
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (imas12). Universidad Complutense, RITIP, Madrid, Spain
| | | | - Carlos Grasa-Lozano
- Department of Infectious Diseases and Tropical Pediatrics, Hospital Universitario La Paz and IdiPaz Foundation, Madrid, Spain
- RITIP, Translational Research Network in Pediatric Infectious Diseases, CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Universidad Autónoma, Madrid, Spain
- Department of Pediatrics, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - María José Cilleruelo
- Department of Pediatrics, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Ana Álvarez
- Department of Pediatrics, Hospital Universitario de Getafe, Getafe, Madrid, Spain
| | - Cristina Comín-Cabrera
- Department of Pediatrics, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
| | - María Penin
- Department of Pediatrics, Hospital, Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Emilia Cercenado
- Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Rut Del Valle
- Department of Pediatrics, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - Miguel Ángel Roa
- Department of Pediatrics, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain
| | | | - Cristina Calvo
- Department of Infectious Diseases and Tropical Pediatrics, Hospital Universitario La Paz and IdiPaz Foundation, Madrid, Spain
- RITIP, Translational Research Network in Pediatric Infectious Diseases, CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Universidad Autónoma, Madrid, Spain
| | - Jesús Saavedra-Lozano
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Universidad Complutense, Madrid, Spain
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López Martín D, Piñeiro Pérez R, Martínez Campos L, Ares Álvarez J, de la Calle Cabrera T, Jiménez Huerta I, Khodayar-Pardo P, Lupiani Castellanos P, Baquero-Artigao F. Update of the consensus document on the aetiology, diagnosis and treatment of acute otitis media and sinusitis. An Pediatr (Barc) 2023; 98:362-372. [PMID: 37127475 DOI: 10.1016/j.anpede.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/07/2023] [Indexed: 05/03/2023] Open
Abstract
Update of the consensus on acute otitis media (AOM) (2012) and sinusitis (2013) following the introduction of pneumococcal vaccines in the immunization schedule, and related changes, such as epidemiological variation, colonization by of nonvaccine serotypes and emerging antimicrobial resistances. A majority of studies show that the introduction of the pneumococcal 13-valent conjugate vaccine has been followed by a reduction in the nasopharyngeal carriage of pneumococcus, with an increase in the proportion of drug-resistant nonvaccine serotypes. The diagnosis of AOM is still clinical, although more stringent criteria are proposed, which are based on the visualization of abnormalities in the tympanic membrane and the findings of pneumatic otoscopy performed by trained clinicians. The routine diagnosis of sinusitis is also clinical, and the use of imaging is restricted to the assessment of complications. Analgesia with acetaminophen or ibuprofen is the cornerstone of AOM management; watchful waiting or delayed antibiotic prescription may be suitable strategies in select patients. The first-line antibiotic drug in children with AOM and sinusitis and moderate to severe disease is still high-dose amoxicillin, or amoxicillin-clavulanic acid in select cases. Short-course regimens lasting 5-7 days are recommended for patients with uncomplicated disease, no risk factors and a mild presentation. In allergic patients, the selection of the antibiotic agent must be individualized based on severity and whether or not the allergy is IgE-mediated. In recurrent AOM, the choice between watchful waiting, antibiotic prophylaxis or surgery must be individualized based on the clinical characteristics of the patient.
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Affiliation(s)
- David López Martín
- Servicio de Pediatría, Hospital Costa del Sol, Marbella, Málaga, Sociedad Española de Infectología Pediátrica (SEIP).
| | - Roi Piñeiro Pérez
- Servicio de Pediatría, Hospital Universitario General de Villalba, Madrid, Fundación Idipaz. CIBERINFEC ISCIII, Red de Investigación traslacional en Infectología Pediátrica, Madrid, Sociedad Española de Infectología Pediátrica (SEIP)
| | - Leticia Martínez Campos
- Infectología Pediátrica, Servicio de Pediatría, Hospital Universitario Torrecárdenas, Almería, Sociedad Española de Infectología Pediátrica (SEIP)
| | - Josefa Ares Álvarez
- Centro de Saúde Virxe Peregrina, Pontevedra, Sociedad Española de Infectología Pediátrica (SEIP)
| | - Teresa de la Calle Cabrera
- Área C.S. Tamames, Salamanca, Asociación Española de Pediatría Extrahospitalaria y Atención Primaria (SEPEAP)
| | - Ignacio Jiménez Huerta
- Otorrinolaringología, Hospital Universitario 12 de octubre, Madrid, Otorrinolaringología, Universidad Complutense, Madrid, Sociedad Española de Otorinolaringología y Cirugía de Cabeza y Cuello (SEORL-CCC)
| | - Parisá Khodayar-Pardo
- Servicio de Pediatría, Hospital Clínico Universitario de Valencia, Facultad de Medicina, Universitat de València, Sociedad Española de Urgencias de Pediatría (SEUP)
| | | | - Fernando Baquero-Artigao
- Servicio de Pediatría y Enfermedades Infecciosas, Hospital Universitario La Paz, Fundación Idipaz, CIBERINFEC ISCIII, Red de Investigación traslacional en Infectología Pediátrica, Madrid, Sociedad Española de Infectología Pediátrica (SEIP)
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17
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Capilla-Miranda A, Plaza-López D, Garcia-Clemente P, Baquero-Artigao F. Intermittent bladder irrigation with liposomal amphotericin B for the treatment of fluconazole-resistant Meyerozyma guilliermondii cystitis in an immunosuppressed adolescent. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:253-254. [PMID: 36868980 DOI: 10.1016/j.eimce.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/12/2022] [Indexed: 03/05/2023]
Affiliation(s)
- Ana Capilla-Miranda
- Servicio de Inmunología, Reumatología e Infectología Pediátrica, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
| | - Diego Plaza-López
- Servicio de Hemato-Oncología Pediátrica, Hospital Universitario La Paz, Madrid, Spain
| | | | - Fernando Baquero-Artigao
- Servicio de Pediatría, Enfermedades Infecciosas y Patología Tropical, Hospital Universitario La Paz, Madrid, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
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18
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Buonsenso D, Noguera-Julian A, Moroni R, Hernández-Bartolomé A, Fritschi N, Lancella L, Cursi L, Soler-Garcia A, Krüger R, Feiterna-Sperling C, Sali M, Lo Vecchio A, Scarano S, Hernanz Lobo A, Espiau M, Soriano-Arandes A, Cetin BS, Brinkmann F, Ozere I, Baquero-Artigao F, Tsolia M, Milheiro Silva T, Bustillo-Alonso M, Martín Nalda A, Mancini M, Starshinova A, Ritz N, Velizarova S, Ferreras-Antolín L, Götzinger F, Bilogortseva O, Chechenyeva V, Tebruegge M, Santiago-García B. Performance of QuantiFERON-TB Gold Plus assays in paediatric tuberculosis: a multicentre PTBNET study. Thorax 2023; 78:288-296. [PMID: 36283826 DOI: 10.1136/thorax-2022-218929] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/26/2022] [Indexed: 11/11/2022]
Abstract
RATIONALE In 2016, a new interferon-gamma release assay (IGRA) was introduced, QuantiFERON-TB Gold Plus (QFT-Plus), claimed to have improved sensitivity in active tuberculosis (TB). OBJECTIVES This study aimed to determine the performance of QFT-Plus, compared with previous generation IGRAs and the tuberculin skin test (TST), in children with TB in Europe. METHODS Multicentre, ambispective cohort study within the Paediatric Tuberculosis Network European Trials Group (ptbnet), a dedicated paediatric TB research network comprising >300 members, capturing TB cases <18 years-of-age diagnosed between January 2009 and December 2019. MEASUREMENTS AND MAIN RESULTS 1001 TB cases from 16 countries were included (mean age (IQR) 5.6 (2.4-12.1) years). QFT-Plus was performed in 358, QFT Gold in-Tube (QFT-GIT) in 600, T-SPOT.TB in 58 and TST in 636 cases. The overall test sensitivities were: QFT-Plus 83.8% (95% CI 80.2% to 87.8%), QFT-GIT 85.5% (95% CI 82.7% to 88.3%), T-SPOT.TB 77.6% (95% CI 66.9% to 88.3%) and TST (cut-off ≥10 mm) 83.3% (95% CI 83.3% to 86.2%). There was a trend for tests to have lower sensitivity in patients with miliary and/or central nervous system (CNS) TB (73.1%, 70.9%, 63.6% and 43.5%, respectively), and in immunocompromised patients (75.0%, 59.6%, 45.5% and 59.1%, respectively). CONCLUSIONS The results indicate that the latest generation IGRA assay, QFT-Plus, does not perform better than previous generation IGRAs or the TST in children with TB disease. Overall, tests performed worse in CNS and miliary TB, and in immunocompromised children. None of the tests evaluated had sufficiently high sensitivity to be used as a rule-out test in children with suspected TB.
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Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie - Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Milano, Italy.,Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Antoni Noguera-Julian
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.,Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain
| | - Rossana Moroni
- Direzione Scientifica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Angel Hernández-Bartolomé
- Paediatric Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain. Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas {CIBER INFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Nora Fritschi
- Mycobacterial and Migrant Health Research Group, University of Basel Children's Hospital Basel and Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Laura Lancella
- Paediatric Infectious Diseases Unit, Bambino Gesù Children Hospital, Rome, Italy
| | - Laura Cursi
- Paediatric Infectious Diseases Unit, Bambino Gesù Children Hospital, Rome, Italy
| | - Aleix Soler-Garcia
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Renate Krüger
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin, Berlin, Germany
| | - Cornelia Feiterna-Sperling
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin, Berlin, Germany
| | - Michela Sali
- Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie - Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Milano, Italy.,Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Pediatric Infectious Diseases Unit, University of Naples Federico II, Naples, Italy
| | - Sara Scarano
- Department of Translational Medical Sciences, Pediatric Infectious Diseases Unit, University of Naples Federico II, Naples, Italy
| | - Alicia Hernanz Lobo
- Paediatric Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain. Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas {CIBER INFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Espiau
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Antonio Soriano-Arandes
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Benhur Sirvan Cetin
- Department of Pediatric Infectious Diseases, Erciyes University, Kayseri, Turkey
| | - Folke Brinkmann
- Department of Paediatric Pulmonology, Children's Hospital, Ruhr-University, Bochum, Germany
| | | | - Fernando Baquero-Artigao
- Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain.,Hospital Infantil La Paz, Madrid, Spain.,CIBERINFEC, ISCIII, Madrid, Spain
| | - Maria Tsolia
- Panagiotis & Aglaia Kyriakou Children's Hospital, Athens, Greece
| | | | | | - Andrea Martín Nalda
- Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Margherita Mancini
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Anna Starshinova
- St. Petersburg Scientific Research Institute of Phthisiopulmonology, St. Petersburg, Russian Federation
| | - Nicole Ritz
- Mycobacterial and Migrant Health Research Group, University of Basel Children's Hospital Basel and Department of Clinical Research, University of Basel, Basel, Switzerland.,Department of Paediatrics and Paediatric Infectious Diseases, Children's Hospital Lucerne Lucerne Cantonal Hospital, Lucerne, Switzerland.,Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | | | - Laura Ferreras-Antolín
- Paediatric Infectious Diseases Unit, St. George's University Hospitals NHS Foundation Trust, London, UK
| | - Florian Götzinger
- Department of Paediatric and Adolescent Medicine, National Reference Centre for Childhood Tuberculosis, Klinik Ottakring, Vienna, Austria
| | - Olga Bilogortseva
- Ukraine. Department of Children Phthisiology, National Institution of Phthisiology and Pulmonology of National Academy of Medical sciences of Ukraine, Kiev, Ukraine.,Infectious diseases Centre «Clinic for treatment of children with HIV/AIDS» National Specialized Children's Hospital 'OKHMATDYT', Kiev, Ukraine
| | - Vira Chechenyeva
- Ukraine. Department of Children Phthisiology, National Institution of Phthisiology and Pulmonology of National Academy of Medical sciences of Ukraine, Kiev, Ukraine.,Infectious diseases Centre «Clinic for treatment of children with HIV/AIDS» National Specialized Children's Hospital 'OKHMATDYT', Kiev, Ukraine
| | - Marc Tebruegge
- Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia .,Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Begoña Santiago-García
- Paediatric Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain. Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas {CIBER INFEC), Instituto de Salud Carlos III, Madrid, Spain
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Soriano-Ramos M, Esquivel-De la Fuente E, Albert Vicent E, de la Calle M, Baquero-Artigao F, Domínguez-Rodríguez S, Cabanes M, Gómez-Montes E, Goncé A, Valdés-Bango M, Viñuela-Benéitez MC, Muñoz-Chápuli Gutiérrez M, Saavedra-Lozano J, Cuadrado Pérez I, Encinas B, Castells Vilella L, de la Serna Martínez M, Tagarro A, Rodríguez-Molino P, Giménez Quiles E, García Alcázar D, García Burguillo A, Folgueira MD, Navarro D, Blázquez-Gamero D. The role of the T-cell mediated immune response to Cytomegalovirus infection in intrauterine transmission. PLoS One 2023; 18:e0281341. [PMID: 36745589 PMCID: PMC9901742 DOI: 10.1371/journal.pone.0281341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 01/23/2023] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Prognostic markers for fetal transmission of Cytomegalovirus (CMV) infection during pregnancy are poorly understood. Maternal CMV-specific T-cell responses may help prevent fetal transmission and thus, we set out to assess whether this may be the case in pregnant women who develop a primary CMV infection. METHODS A multicenter prospective study was carried out at 8 hospitals in Spain, from January 2017 to April 2020. Blood samples were collected from pregnant women at the time the primary CMV infection was diagnosed to assess the T-cell response. Quantitative analysis of interferon producing specific CMV-CD8+/CD4+ cells was performed by intracellular cytokine flow cytometry. RESULTS In this study, 135 pregnant women with a suspected CMV infection were evaluated, 60 of whom had a primary CMV infection and samples available. Of these, 24 mothers transmitted the infection to the fetus and 36 did not. No association was found between the presence of specific CD4 or CD8 responses against CMV at the time maternal infection was diagnosed and the risk of fetal transmission. There was no transmission among women with an undetectable CMV viral load in blood at diagnosis. CONCLUSIONS In this cohort of pregnant women with a primary CMV infection, no association was found between the presence of a CMV T-cell response at the time of maternal infection and the risk of intrauterine transmission. A detectable CMV viral load in the maternal blood at diagnosis of the primary maternal infection may represent a relevant biomarker associated with fetal transmission.
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Affiliation(s)
- María Soriano-Ramos
- Department of Neonatology, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto de Investigación Hospital 12 de Octubre (imas12), Fundación Biomédica del Hospital Universitario 12 de Octubre (FBHU12O), Madrid, Spain
- * E-mail:
| | - Estrella Esquivel-De la Fuente
- Instituto de Investigación Hospital 12 de Octubre (imas12), Fundación Biomédica del Hospital Universitario 12 de Octubre (FBHU12O), Madrid, Spain
| | - Eliseo Albert Vicent
- Microbiology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | - Fernando Baquero-Artigao
- Department of Infectious Diseases and Tropical Pediatrics, Hospital Universitario Infantil La Paz, Madrid, Spain
| | - Sara Domínguez-Rodríguez
- Instituto de Investigación Hospital 12 de Octubre (imas12), Fundación Biomédica del Hospital Universitario 12 de Octubre (FBHU12O), Madrid, Spain
| | - María Cabanes
- Obstetrics Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Enery Gómez-Montes
- Obstetrics Department, Fetal Medicine Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Anna Goncé
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetricia i Neonatologia, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Marta Valdés-Bango
- Fetal Medicine Research Center, BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecología, Obstetricia i Neonatologia, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - Mª Carmen Viñuela-Benéitez
- Obstetrics Department, Hospital Gregorio Marañón, Complutense University, Health Research Institute Gregorio Marañón, Madrid, Spain
| | - Mar Muñoz-Chápuli Gutiérrez
- Obstetrics Department, Hospital Gregorio Marañón, Complutense University, Health Research Institute Gregorio Marañón, Madrid, Spain
| | - Jesús Saavedra-Lozano
- Hospital General Universitario Gregorio Marañón, Pediatric Infectious Diseases Unit, Universidad Complutense, Madrid, Spain
| | | | - Begoña Encinas
- Obstetrics Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Laura Castells Vilella
- Department of Neonatology, Hospital Universitari General de Catalunya, Grupo Quiron Salud, Sant Cugat del Vallès, Barcelona, Spain
| | | | - Alfredo Tagarro
- Paediatrics Department, Paediatrics Research Group, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, Madrid, Spain
| | - Paula Rodríguez-Molino
- Department of Infectious Diseases and Tropical Pediatrics, Hospital Universitario Infantil La Paz, Madrid, Spain
| | - Estela Giménez Quiles
- Microbiology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Diana García Alcázar
- Obstetrics Department, Fetal Medicine Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - David Navarro
- Microbiology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Daniel Blázquez-Gamero
- Instituto de Investigación Hospital 12 de Octubre (imas12), Fundación Biomédica del Hospital Universitario 12 de Octubre (FBHU12O), Madrid, Spain
- Pediatric Infectious Diseases Unit, Hospital Universitario 12 de Octubre, Universidad Complutense, RITIP, Madrid, Spain
| | - the CYTRIC Study Group
- Pediatric Infectious Diseases Unit, Hospital Universitario 12 de Octubre, Universidad Complutense, RITIP, Madrid, Spain
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Calzada-Hernández J, Anton J, Martín de Carpi J, López-Montesinos B, Calvo I, Donat E, Núñez E, Blasco Alonso J, Mellado MJ, Baquero-Artigao F, Leis R, Vegas-Álvarez AM, Medrano San Ildefonso M, Pinedo-Gago MDC, Eizaguirre FJ, Tagarro A, Camacho-Lovillo M, Pérez-Gorricho B, Gavilán-Martín C, Guillén S, Sevilla-Pérez B, Peña-Quintana L, Mesa-Del-Castillo P, Fortuny C, Tebruegge M, Noguera-Julian A. Dual latent tuberculosis screening with tuberculin skin tests and QuantiFERON-TB assays before TNF-α inhibitor initiation in children in Spain. Eur J Pediatr 2023; 182:307-317. [PMID: 36335186 PMCID: PMC9829583 DOI: 10.1007/s00431-022-04640-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 11/07/2022]
Abstract
UNLABELLED Tumor-necrosis-factor-α inhibitors (anti-TNF-α) are associated with an increased risk of tuberculosis (TB) disease, primarily due to reactivation of latent TB infection (LTBI). We assessed the performance of parallel LTBI screening with tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube assays (QFT-GIT) before anti-TNF-α treatment in children with immune-mediated inflammatory disorders in a low TB-burden setting. We conducted a multicenter cohort study involving 17 pediatric tertiary centers in Spain. LTBI was defined as the presence of a positive TST and/or QFT-GIT result without clinical or radiological signs of TB disease. A total of 270 patients (median age:11.0 years) were included, mainly with rheumatological (55.9%) or inflammatory bowel disease (34.8%). Twelve patients (4.4%) were diagnosed with TB infection at screening (LTBI, n = 11; TB disease, n = 1). Concordance between TST and QFT-GIT results was moderate (TST+/QFT-GIT+, n = 4; TST-/QFT-GIT+, n = 3; TST+/QFT-GIT-, n = 5; kappa coefficient: 0.48, 95% CI: 0.36-0.60). Indeterminate QFT-GIT results occurred in 10 patients (3.7%) and were associated with young age and elevated C-reactive protein concentrations. Eleven of 12 patients with TB infection uneventfully completed standard LTBI or TB treatment. During a median follow-up period of 6.4 years, only 2 patients developed TB disease (incidence density: 130 (95% CI: 20-440) per 100,000 person-years), both probable de novo infections. CONCLUSION A substantial number of patients were diagnosed with LTBI during screening. The dual strategy identified more cases than either of the tests alone, and test agreement was only moderate. Our data show that in children in a low TB prevalence setting, a dual screening strategy with TST and IGRA before anti-TNF-α treatment is effective. WHAT IS KNOWN • The optimal screening strategy for latent tuberculosis in children with immune-mediated inflammatory disorders remains uncertain. • Children receiving anti-TNF-α drugs are at increased risk of developing severe tuberculosis disease. WHAT IS NEW • A dual screening strategy, using TST and an IGRA assay, identified more children with latent tuberculosis than either of the tests alone. • Identification and treatment of latent tuberculosis before initiation of anti-TNF-α therapy averted incident tuberculosis cases.
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Affiliation(s)
- Joan Calzada-Hernández
- grid.411160.30000 0001 0663 8628Pediatric Rheumatology Division, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Jordi Anton
- grid.411160.30000 0001 0663 8628Pediatric Rheumatology Division, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Javier Martín de Carpi
- grid.5841.80000 0004 1937 0247Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain ,grid.411160.30000 0001 0663 8628Servei de Gastroenterologia, Hepatologia I Nutrició Pediàtrica, Hospital Sant Joan de Déu - Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Berta López-Montesinos
- grid.84393.350000 0001 0360 9602Rheumatology Unit, Pediatrics Department, University Hospital La Fe, Valencia, Spain
| | - Inmaculada Calvo
- grid.84393.350000 0001 0360 9602Rheumatology Unit, Pediatrics Department, University Hospital La Fe, Valencia, Spain
| | - Ester Donat
- grid.84393.350000 0001 0360 9602Pediatric Gastroenterology and Hepatology Unit, Pediatrics Department, University Hospital La Fe, Valencia, Spain
| | - Esmeralda Núñez
- grid.411457.2UGC de Pediatría, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Javier Blasco Alonso
- grid.411457.2UGC de Pediatría, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - María José Mellado
- Servicio de Pediatria, Enfermedades Infecciosas Y Patología Tropical, Hospital La Paz, Madrid, Spain ,Red de Investigación Translacional en Infectología Pediátrica (RITIP), Madrid, Spain ,grid.512890.7Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Fernando Baquero-Artigao
- Servicio de Pediatria, Enfermedades Infecciosas Y Patología Tropical, Hospital La Paz, Madrid, Spain ,Red de Investigación Translacional en Infectología Pediátrica (RITIP), Madrid, Spain ,grid.512890.7Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Rosaura Leis
- grid.411048.80000 0000 8816 6945Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Pediatrics Department, University Clinical Hospital of Santiago (CHUS), Santiago de Compostela, Spain
| | - Ana María Vegas-Álvarez
- grid.411280.e0000 0001 1842 3755Gastroenterología Infantil, Hospital Universitario Río Hortega de Valladolid, Valladolid, Spain
| | - Marta Medrano San Ildefonso
- grid.411106.30000 0000 9854 2756Reumatología Pediátrica, Hospital Universitario Miguel Servet, Saragossa, Spain
| | | | - Francisco Javier Eizaguirre
- grid.414651.30000 0000 9920 5292Unidad de Gastroenterología Infantil, Hospital Universitario Donostia, San Sebastián, Spain
| | - Alfredo Tagarro
- Red de Investigación Translacional en Infectología Pediátrica (RITIP), Madrid, Spain ,grid.119375.80000000121738416Paediatrics Department, Hospital Universitario Infanta Sofía; Paediatrics Research Group, Universidad Europea de Madrid, Madrid, Spain ,grid.144756.50000 0001 1945 5329Fundación de Investigación Biomédica Hospital 12 de Octubre, Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
| | - Marisol Camacho-Lovillo
- grid.411109.c0000 0000 9542 1158Servicio de Inmunología, Reumatología e Infectología Pediátrica, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Beatriz Pérez-Gorricho
- grid.411107.20000 0004 1767 5442Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - César Gavilán-Martín
- grid.411263.3Servicio de Pediatría, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Sara Guillén
- grid.512890.7Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain ,grid.411244.60000 0000 9691 6072Department of Pediatrics, Hospital Universitario de Getafe, Madrid, Spain
| | - Belén Sevilla-Pérez
- grid.459499.cUnidad de Reumatología, Servicio de Pediatría del Hospital Universitario San Cecilio de Granada, Granada, Spain
| | - Luis Peña-Quintana
- Pediatric Gastroenterology, Hepatology and Nutrition Unit, Mother and Child Insular University Hospital,, Las Palmas, Spain ,grid.512890.7Centro de Investigación Biomédica en Red de Obesidad Y Nutrición (CIBEROBN), Madrid, Spain ,grid.4521.20000 0004 1769 9380University Institute for Research in Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Pablo Mesa-Del-Castillo
- grid.411372.20000 0001 0534 3000Department of Rheumatology, Hospital Clínico Universitario Virgen de La Arrixaca, Murcia, Spain
| | - Clàudia Fortuny
- grid.5841.80000 0004 1937 0247Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain ,Red de Investigación Translacional en Infectología Pediátrica (RITIP), Madrid, Spain ,grid.411160.30000 0001 0663 8628Malalties Infeccioses I Resposta Inflamatòria Sistèmica en Pediatria, Unitat d’Infeccions, Servei de Pediatria, Institut de Recerca Sant Joan de Déu, Barcelona, Spain ,grid.466571.70000 0004 1756 6246Centro de Investigación Biomédica en Red de Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Marc Tebruegge
- grid.83440.3b0000000121901201Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, UK ,grid.1008.90000 0001 2179 088XDepartment of Paediatrics, University of Melbourne, Parkville, VIC Australia ,Department of Paediatrics, Klinik Ottakring, Wiener Gesundheitsverbund, Vienna, Austria
| | - Antoni Noguera-Julian
- Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain. .,Red de Investigación Translacional en Infectología Pediátrica (RITIP), Madrid, Spain. .,Malalties Infeccioses I Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Institut de Recerca Sant Joan de Déu, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain.
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21
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de la Calle M, Rodríguez-Molino P, Romero Gómez MP, Baquero-Artigao F. Cytomegalovirus seroprevalence in pregnant women in Madrid: First step for a systematic screening. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:55-56. [PMID: 36167640 DOI: 10.1016/j.eimce.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/23/2022] [Accepted: 01/26/2022] [Indexed: 01/11/2023]
Affiliation(s)
- María de la Calle
- Servicio de Obstetricia y Ginecología, Hospital Universitario La Paz, Madrid, Spain
| | - Paula Rodríguez-Molino
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz, Madrid, Spain.
| | | | - Fernando Baquero-Artigao
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz, CIBER Enfermedades Infecciosas (ISCIII), Madrid, Spain
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22
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Goycochea-Valdivia WA, Melendo Pérez S, Aguilera-Alonso D, Escosa-Garcia L, Martínez Campos L, Baquero-Artigao F. Position statement of the Spanish Society of Paediatric Infectious Diseases on the introduction, implementation and assessment of antimicrobial stewardship programmes in paediatric hospitals. An Pediatr (Barc) 2022; 97:351.e1-351.e12. [PMID: 36243665 DOI: 10.1016/j.anpede.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023] Open
Abstract
In the past few years, antimicrobial resistance has increased, becoming a serious public health problem. The irrational use of antimicrobials is one of the main contributors to antimicrobial resistance. The paediatric population is not free from this problem, as antimicrobials are widely prescribed in this age group, often inappropriately. The introduction of antimicrobial stewardship programmes (ASPs) has proven crucial in curbing the emergence of antimicrobial resistance. At the international level, the need to develop specific paediatric ASPs has been recognised on account of the differences between adult and paediatric patients as concerns infection and approaches to diagnosis and treatment. For this reason, paediatric ASPs should be multidisciplinary programmes led by paediatric infectious disease specialists and use specific paediatric indicators (such as days of treatment, antimicrobial susceptibility patterns in the paediatric population, or clinical indicators) to help identify areas of improvement and develop effective targeted interventions. On the other hand, the support and leadership of the pertinent scientific societies are also essential. The purpose of this document is to present the position of the Sociedad Española de Infectología Pediátrica (SEIP, Spanish Society of Paediatric Infectious Diseases) concerning the implementation of paediatric ASPs in hospitals in Spain and to provide tools to facilitate their application in hospitals throughout the regional health care systems in the country.
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Affiliation(s)
| | - Susana Melendo Pérez
- Unidad de Patología infecciosa e Inmunodeficiencias de Pediatría, Servicio de Pediatría, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - David Aguilera-Alonso
- Sección de Enfermedades Infecciosas, Servicio de Pediatría, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital Universitario Gregorio Marañón, Madrid. CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Escosa-Garcia
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales, Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid. CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Fernando Baquero-Artigao
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales, Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid. CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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23
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Aguilera-Alonso D, Solís-García G, Noguera-Julian A, González-Martín J, Román Cobeña A, Baquero-Artigao F, Toro Rueda C, Rodríguez-Molino P, Bloise Sánchez I, Vallmanya T, Bernet-Sánchez A, Minguell Domingo L, Rubio A, Saavedra-Lozano J, Ruiz-Serrano MJ, Blázquez-Gamero D, López-Roa P, Gomez-Pastrana D, López Prieto MD, López Medina EM, Gil-Brusola A, Martín Nalda A, Soriano-Arandes A, Tórtola T, Falcon-Neyra L, González Galán V, Tebruegge M, Santiago-García B. Accuracy of Xpert Ultra for the diagnosis of paediatric tuberculosis in a low TB burden country: a prospective multicentre study. Thorax 2022; 77:1023-1029. [PMID: 36357344 DOI: 10.1136/thorax-2021-218378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 07/28/2022] [Indexed: 11/04/2022]
Abstract
IntroductionChildhood pulmonary tuberculosis (TB) remains a diagnostic challenge. This study aimed to evaluate the performance of Xpert Ultra for the diagnosis of pulmonary TB in children in a low TB prevalence setting.MethodsProspective, multicentre, diagnostic accuracy study. Children with clinical or radiological suspicion of pulmonary TB were recruited at 11 paediatric units in Spain. Up to three gastric or sputum specimens were taken on 3 consecutive days, and analysed by Xpert MTB/RIF, Xpert Ultra and culture in parallel.Results86 children were included (median age 4.9 years, IQR 2.0–10.0; 51.2% male). The final diagnosis was pulmonary TB in 75 patients (87.2%); 33 (44.0%) were microbiologically confirmed. A total of 219 specimens, comprising gastric aspirates (n=194; 88.6%) and sputum specimens (n=25; 11.4%), were analysed. Using culture as reference standard and comparing individual specimens, the sensitivity was 37.8% (14/37) for Xpert MTB/RIF and 81.1% (30/37) for Xpert Ultra (p<0.001); specificity was 98.4% (179/182) and 93.4% (170/182), respectively (p=0.02). In the per-patient analysis, considering positive results on any specimen, the sensitivity was 42.9% (9/21) for Xpert MTB/RIF and 81.0% for Xpert Ultra (17/21, p=0.01); specificity was 96.9% (63/65) and 87.7% (57/65, p=0.07), respectively.ConclusionsIn children with pulmonary TB in a low burden setting, Xpert Ultra has significantly higher sensitivity than the previous generation of Xpert assay and only marginally lower specificity. Therefore, in children undergoing evaluation for suspected pulmonary TB, Xpert Ultra should be used in preference to Xpert MTB/RIF whenever possible.
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Grasa C, Ochoa B, Baquero-Artigao F, San Román S, Galán-Gómez V, Del Rosal T, Calvo C, Pérez-Martínez A. Disseminated tuberculosis infection in a CAR T-cell recipient. Pediatr Blood Cancer 2022; 69:e29615. [PMID: 35187816 DOI: 10.1002/pbc.29615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 12/21/2022]
Affiliation(s)
- Carlos Grasa
- Pediatric Infectious Diseases Department, Hospital Universitario la Paz, Madrid, Spain.,Instituto de investigación sanitaria del Hospital Universitario la Paz (IdiPAZ), Madrid, Spain.,CIBERINFEC - CIBER of Infectious Diseases (Instituto de Salud Carlos III - ISCIII), Madrid, Spain
| | - Bárbara Ochoa
- Pediatric Onco-Hematology Department, Hospital Universitario la Paz, Madrid, Spain
| | - Fernando Baquero-Artigao
- Pediatric Infectious Diseases Department, Hospital Universitario la Paz, Madrid, Spain.,Instituto de investigación sanitaria del Hospital Universitario la Paz (IdiPAZ), Madrid, Spain.,CIBERINFEC - CIBER of Infectious Diseases (Instituto de Salud Carlos III - ISCIII), Madrid, Spain
| | - Sonsoles San Román
- Instituto de investigación sanitaria del Hospital Universitario la Paz (IdiPAZ), Madrid, Spain.,Pediatric Onco-Hematology Department, Hospital Universitario la Paz, Madrid, Spain
| | - Víctor Galán-Gómez
- Pediatric Onco-Hematology Department, Hospital Universitario la Paz, Madrid, Spain
| | - Teresa Del Rosal
- Pediatric Infectious Diseases Department, Hospital Universitario la Paz, Madrid, Spain.,Instituto de investigación sanitaria del Hospital Universitario la Paz (IdiPAZ), Madrid, Spain.,Center for Biomedical Network Research on Rare Diseases (CIBERER U767), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Calvo
- Pediatric Infectious Diseases Department, Hospital Universitario la Paz, Madrid, Spain.,Instituto de investigación sanitaria del Hospital Universitario la Paz (IdiPAZ), Madrid, Spain.,CIBERINFEC - CIBER of Infectious Diseases (Instituto de Salud Carlos III - ISCIII), Madrid, Spain
| | - Antonio Pérez-Martínez
- Instituto de investigación sanitaria del Hospital Universitario la Paz (IdiPAZ), Madrid, Spain.,Pediatric Onco-Hematology Department, Hospital Universitario la Paz, Madrid, Spain
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25
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Villaverde S, Esquivel E, Baquero-Artigao F, Noguera-Julian A, Frick MA, Rojo P, Blázquez-Gamero D. Impact of the COVID-19 Pandemic on the Diagnosis of Congenital Cytomegalovirus Infection in Spain. Pediatr Infect Dis J 2022; 41:590-592. [PMID: 35363648 PMCID: PMC9177127 DOI: 10.1097/inf.0000000000003532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 11/29/2022]
Abstract
We conducted an observational study performed within the Spanish Registry of Children with congenital cytomegalovirus (cCMV) to evaluate the impact of the COVID-19 pandemic on the diagnosis of new cases of cCMV. Our study suggest a significant decrease in the monthly rate of new cCMV diagnoses during the COVID-19 pandemic.
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Affiliation(s)
- Serena Villaverde
- From the Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
- Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Estrella Esquivel
- Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Fernando Baquero-Artigao
- Pediatrics, Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Instituto Investigación Hospital La Paz (IDIPaz), Madrid, Spain
- Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain
| | - Antoni Noguera-Julian
- Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d’Infeccions, Servei de Pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
- Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - Marie Antoinette Frick
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Department of Pediatrics, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Pablo Rojo
- From the Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
- Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
- Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain
| | - Daniel Blázquez-Gamero
- From the Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
- Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
- Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain
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Aguilera-Alonso D, Kirchschläger Nieto S, Ara Montojo MF, Sanz Santaeufemia FJ, Saavedra-Lozano J, Soto B, Caminoa MB, Berzosa A, Prieto Tato L, Cercenado E, Tagarro A, Molina Arana D, Alonso Sanz M, Romero Gómez MP, Chaves Sánchez F, Baquero-Artigao F. Staphylococcus aureus Community-acquired Pneumonia in Children After 13-Valent Pneumococcal Vaccination (2008-2018): Epidemiology, Clinical Characteristics and Outcomes. Pediatr Infect Dis J 2022; 41:e235-e242. [PMID: 35333816 DOI: 10.1097/inf.0000000000003503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The epidemiology of community-acquired pneumonia (CAP) has changed, influenced by sociosanitary conditions and vaccination status. We aimed to analyze the recent epidemiology of bacterial CAP in hospitalized children in a setting with high pneumococcal vaccination coverage and to describe the clinical characteristics of pediatric Staphylococcus aureus CAP. METHODS Children <17 years old hospitalized from 2008 to 2018 with bacterial CAP in 5 tertiary hospitals in Spain were included. Cases with pneumococcal CAP were randomly selected as comparative group following a case-control ratio of 2:1 with S. aureus CAP. RESULTS A total of 313 bacterial CAP were diagnosed: Streptococcus pneumoniae CAP (n = 236, 75.4%), Streptococcus pyogenes CAP (n = 43, 13.7%) and S. aureus CAP (n = 34, 10.9%). Throughout the study period, the prevalence of S. pyogenes increased (annual percentage change: +16.1% [95% CI: 1.7-32.4], P = 0.031), S. pneumoniae decreased (annual percentage change: -4.4% [95 CI: -8.8 to 0.2], P = 0.057) and S. aureus remained stable. Nine isolates of S. aureus (26.5%) were methicillin-resistant. Seventeen cases (50%) with S. aureus CAP had some pulmonary complication and 21 (61.7%) required intensive care. S. pneumoniae CAP showed a trend toward higher prevalence of pulmonary complications compared with S. aureus CAP (69.1% vs. 50.0%, P = 0.060), including higher frequency of pulmonary necrosis (32.4% vs. 5.9%, P = 0.003). CONCLUSIONS The incidence of S. aureus CAP in children remained stable, whereas the prevalence of pneumococcal CAP decreased and S. pyogenes CAP increased. Patients with S. aureus presented a high frequency of severe outcomes, but a lower risk of pulmonary complications than patients with S. pneumoniae.
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Affiliation(s)
- David Aguilera-Alonso
- From the Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, Unidad de Investigación Materno-Infantil Fundación Familia Alonso (UDIMIFFA), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBER en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | | | - Jesús Saavedra-Lozano
- From the Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital General Universitario Gregorio Marañón, Unidad de Investigación Materno-Infantil Fundación Familia Alonso (UDIMIFFA), Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBER en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Beatriz Soto
- Department of Pediatrics, Hospital de Getafe, Madrid, Spain
| | | | - Arantxa Berzosa
- Department of Pediatrics, Hospital Clinico San Carlos, Madrid, Spain
| | - Luis Prieto Tato
- Department of Pediatric Infectious Diseases, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - Emilia Cercenado
- Department of Microbiology, Hospital General Universitario Gregorio Marañón, CIBERES, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
| | - Alfredo Tagarro
- Department of Pediatrics, Hospital Infanta Sofía, Madrid, Spain
| | | | | | - María Pilar Romero Gómez
- CIBER en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Department of Microbiology, Hospital Universitario La Paz, Madrid, Spain
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García-Boyano M, Baquero-Artigao F, Toro C, Alguacil-Guillén M, Lázaro-Perona F, Calvo C. Mycobacterium mageritense Lymphadenitis in Child. Emerg Infect Dis 2022; 28:752-753. [PMID: 35202540 PMCID: PMC8888222 DOI: 10.3201/eid2803.211486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Although human infections caused by Mycobacterium mageritense are rare, there are some case reports involving sinusitis, pneumonia, and hospital-acquired infections in adults. We report a case of lymphadenitis caused by M. mageritense in a child in Spain.
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Aguilera-Alonso D, Martínez Campos L, Fernández Llamazares CM, Calvo C, Baquero-Artigao F, Baquero Artigao F, Martínez Campos L, Gonzalo de Liria CR, Ramos Amador JT, Launes Montaña C, Suarez Arrabal MC, Escosa García L, Melendo Pérez S, Aguilera Alonso D, Goycoechea Valdivia W, Velasco Arnaiz E, Epalza Ibarrondo C, García Ascaso M. New antibiotic susceptibility testing definitions: «I» no longer means intermediate susceptibility. An Pediatr (Barc) 2022; 96:157-158. [DOI: 10.1016/j.anpede.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/23/2021] [Indexed: 10/19/2022] Open
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Tagarro A, Sanz-Santaeufemia FJ, Grasa C, Cobos E, Yebra J, Alonso-Cadenas JA, Baquero-Artigao F, Mesa-Guzmán JM, Pérez-Seoane B, Calvo C, Herreros ML, Epalza C, Melendo S, Dominguez-Rodriguez S, Vidal P, Pacheco M, Ballesteros A, Bernardino M, Villanueva-Medina S, Rodríguez-Molino P, Miragaya Castro S, Rivière J, Garcés R, Santiago B, Fumadó V, Urretavizcaya-Martínez M, García-García ML, Penín M, Cava F, Sáez E, Iglesias-Bouzas MI, Herrero B, Reinoso TDJ, Moraleda C. Dynamics of Reverse Transcription-Polymerase Chain Reaction and Serologic Test Results in Children with SARS-CoV-2 Infection. J Pediatr 2022; 241:126-132.e3. [PMID: 34571020 PMCID: PMC8463102 DOI: 10.1016/j.jpeds.2021.09.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the time to reverse transcription-polymerase chain reaction (RT-PCR) negativity after the first positive RT-PCR test, factors associated with longer time to RT-PCR negativity, proportion of children seroconverting after proven severe acute respiratory syndrome coronavirus 2 infection, and factors associated with the lack of seroconversion. STUDY DESIGN The Epidemiological Study of Coronavirus in Children of the Spanish Society of Pediatrics is a multicenter study conducted in Spanish children to assess the characteristics of coronavirus disease 2019. In a subset of patients, 3 serial RT-PCR tests on nasopharyngeal swab specimens were performed after the first RT-PCR test, and immunoglobulin G serology for severe acute respiratory syndrome coronavirus 2 antibodies was performed in the acute and follow-up (<14 and ≥14 days after diagnosis) phase. RESULTS In total, 324 patients were included in the study. The median time to RT-PCR negativity was 17 days (IQR, 8-29 days), and 35% of patients remained positive more than 4 weeks after the first RT-PCR test. The probability of RT-PCR negativity did not differ across groups defined by sex, disease severity, immunosuppressive drugs, or clinical phenotype. Globally, 24% of children failed to seroconvert after infection. Seroconversion was associated with hospitalization, persistence of RT-PCR positivity, and days of fever. CONCLUSIONS Time to RT-PCR negativity was long, regardless of the severity of symptoms or other patient features. This finding should be considered when interpreting RT-PCR results in a child with symptoms, especially those with mild symptoms. Seroprevalence and postimmunization studies should consider that 11 in 4 infected children fail to seroconvert.
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Affiliation(s)
- Alfredo Tagarro
- Pediatrics Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain,Pediatrics Research Group, Europea University of Madrid, Madrid, Spain,Fundación de Investigación Biomédica Hospital 12 de Octubre. Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
| | | | - Carlos Grasa
- Pediatrics, Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Instituto Investigación Hospital La Paz (IDIPaz), Madrid, Spain
| | - Elena Cobos
- Fundación de Investigación Biomédica Hospital 12 de Octubre. Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
| | - Julia Yebra
- Pediatrics Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | | | - Fernando Baquero-Artigao
- Pediatrics, Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Instituto Investigación Hospital La Paz (IDIPaz), Madrid, Spain
| | - Juan Miguel Mesa-Guzmán
- Pediatrics Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - Beatriz Pérez-Seoane
- Pediatrics Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - Cristina Calvo
- Pediatrics, Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Instituto Investigación Hospital La Paz (IDIPaz), Madrid, Spain
| | - María Luisa Herreros
- Pediatrics Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - Cristina Epalza
- Fundación de Investigación Biomédica Hospital 12 de Octubre. Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain,Pediatrics Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Susana Melendo
- Infectious Diseases and Pediatric Immunology Unit, Department of Pediatrics, Hospital Universitario Vall d’Hebron, Madrid, Spain
| | - Sara Dominguez-Rodriguez
- Fundación de Investigación Biomédica Hospital 12 de Octubre. Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
| | - Paula Vidal
- Pediatrics Department, Hospital Clínico Universitario Lozano Blesa Zaragoza, Aragón, Spain
| | - Mónica Pacheco
- Pediatrics Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - Alvaro Ballesteros
- Fundación de Investigación Biomédica Hospital 12 de Octubre. Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain
| | - María Bernardino
- Pediatrics Research Group, Europea University of Madrid, Madrid, Spain
| | | | - Paula Rodríguez-Molino
- Pediatrics, Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Instituto Investigación Hospital La Paz (IDIPaz), Madrid, Spain
| | | | - Jacques Rivière
- Infectious Diseases and Pediatric Immunology Unit, Department of Pediatrics, Hospital Universitario Vall d’Hebron, Madrid, Spain
| | - Rosa Garcés
- Pediatrics Department, Hospital Clínico Universitario Lozano Blesa Zaragoza, Aragón, Spain
| | - Begoña Santiago
- Pediatric Infectious Diseases Unit. Department of Pediatrics, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Victoria Fumadó
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario Sant Joan de Deu Barcelona, Barcelona, Spain
| | | | | | - María Penín
- Pediatrics Departament, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - Fernando Cava
- Microbiology Department, UR Salud, Hospital Universitario Infanta Sofía, Madrid, Spain
| | - Elena Sáez
- Microbiology Department, UR Salud, Hospital Universitario Infanta Sofía, Madrid, Spain
| | | | - Blanca Herrero
- Oncology Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Teresa de Jesús Reinoso
- Pediatrics Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain.
| | - Cinta Moraleda
- Fundación de Investigación Biomédica Hospital 12 de Octubre. Instituto de Investigación 12 de Octubre (imas12), Madrid, Spain,Pediatrics Department, Hospital Universitario 12 de Octubre, Madrid, Spain
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Dorado Criado M, Fabra Garrido C, Merino San Martín E, González Arboleya C, Gómez-Arroyo B, González-Donapetry P, Baquero-Artigao F, de la Calle M, Quiles-Melero I, Calvo C. Is an Antenatal Screening for Chlamydia trachomatis Necessary in the Current Society? Pediatr Infect Dis J 2021; 40:1034-1036. [PMID: 34321448 DOI: 10.1097/inf.0000000000003229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A screening of Chlamydia trachomatis infection in young pregnant women (≤25 years old) and their newborns was conducted. A total of 136 women were tested with urine samples in the immediate postpartum period. The prevalence was 18.4% (95% confidence interval [CI]: 11.9-24.9%) (25/136) and the rate of perinatal transmission was 35% (7/20). These results support the need for antenatal screening programs in high-risk women in Madrid (Spain).
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Affiliation(s)
- Marta Dorado Criado
- From the Pediatrics and Infectious Disease Unit; Fundación IdiPaz; Traslational Research Network of Pediatric Infectious Diseases (RITIP)
| | - Celia Fabra Garrido
- From the Pediatrics and Infectious Disease Unit; Fundación IdiPaz; Traslational Research Network of Pediatric Infectious Diseases (RITIP)
| | | | | | | | | | - Fernando Baquero-Artigao
- From the Pediatrics and Infectious Disease Unit; Fundación IdiPaz; Traslational Research Network of Pediatric Infectious Diseases (RITIP)
| | - María de la Calle
- From the Pediatrics and Infectious Disease Unit; Fundación IdiPaz; Traslational Research Network of Pediatric Infectious Diseases (RITIP)
| | | | - Cristina Calvo
- From the Pediatrics and Infectious Disease Unit; Fundación IdiPaz; Traslational Research Network of Pediatric Infectious Diseases (RITIP)
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Campos M, Sempere JM, Galán JC, Moya A, Llorens C, de-Los-Angeles C, Baquero-Artigao F, Cantón R, Baquero F. Simulating the impact of non-pharmaceutical interventions limiting transmission in COVID-19 epidemics using a membrane computing model. ACTA ACUST UNITED AC 2021; 2:uqab011. [PMID: 34642663 PMCID: PMC8499911 DOI: 10.1093/femsml/uqab011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/03/2021] [Indexed: 01/08/2023]
Abstract
Epidemics caused by microbial organisms are part of the natural phenomena of increasing biological complexity. The heterogeneity and constant variability of hosts, in terms of age, immunological status, family structure, lifestyle, work activities, social and leisure habits, daily division of time and other demographic characteristics make it extremely difficult to predict the evolution of epidemics. Such prediction is, however, critical for implementing intervention measures in due time and with appropriate intensity. General conclusions should be precluded, given that local parameters dominate the flow of local epidemics. Membrane computing models allows us to reproduce the objects (viruses and hosts) and their interactions (stochastic but also with defined probabilities) with an unprecedented level of detail. Our LOIMOS model helps reproduce the demographics and social aspects of a hypothetical town of 10 320 inhabitants in an average European country where COVID-19 is imported from the outside. The above-mentioned characteristics of hosts and their lifestyle are minutely considered. For the data in the Hospital and the ICU we took advantage of the observations at the Nursery Intensive Care Unit of the Consortium University General Hospital, Valencia, Spain (included as author). The dynamics of the epidemics are reproduced and include the effects on viral transmission of innate and acquired immunity at various ages. The model predicts the consequences of delaying the adoption of non-pharmaceutical interventions (between 15 and 45 days after the first reported cases) and the effect of those interventions on infection and mortality rates (reducing transmission by 20, 50 and 80%) in immunological response groups. The lockdown for the elderly population as a single intervention appears to be effective. This modeling exercise exemplifies the application of membrane computing for designing appropriate multilateral interventions in epidemic situations.
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Affiliation(s)
- M Campos
- Department of Microbiology, Ramón y Cajal University Hospital, M-607, km 9,1 28034 Madrid, Spain
| | - J M Sempere
- Valencian Research Institute for Artificial Intelligence (VRAIN), Universitat Politècnica de Valencia, Camí de Vera s/n, 46022 Valencia, Spain
| | - J C Galán
- Department of Microbiology, Ramón y Cajal University Hospital, M-607, km 9,1 28034 Madrid, Spain
| | - A Moya
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, M-607, km 9,1. 28034 Madrid, Spain
| | - C Llorens
- Biotechvana, Valencia, CEEI Building, Valencia Technological Park., C. agustín Escardino 9, 46980, Paterna, Valencia, Spain
| | - C de-Los-Angeles
- Nursery Unit, Intensive Care Unit and Pain Therapy, Consortium University General Hospital (CHGUV)., Av. Tres Cruces 2, 46014 Valencia, Spain
| | - F Baquero-Artigao
- Department of Infectious Diseases and Tropical Pediatrics, La Paz University Hospital., Av. Monforte de Lemos 2D, 28029 Madrid, Spain
| | - R Cantón
- Department of Microbiology, Ramón y Cajal University Hospital, M-607, km 9,1 28034 Madrid, Spain
| | - F Baquero
- Department of Microbiology, Ramón y Cajal University Hospital, M-607, km 9,1 28034 Madrid, Spain
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López López S, Del Rosal T, Jiménez Bueno S, Baquero-Artigao F. Septicemia and meningitis associated with Haemophilus influenzae type b vaccine failure. Enferm Infecc Microbiol Clin (Engl Ed) 2021; 39:417-418. [PMID: 34362705 DOI: 10.1016/j.eimce.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 06/13/2023]
Affiliation(s)
- Sara López López
- Servicio de Pediatría, Complejo Hospitalario Universitario Insular Materno Infantil de Canarias, Las Palmas de Gran Canaria, Gran Canaria, Spain
| | - Teresa Del Rosal
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz, Madrid, Spain.
| | | | - Fernando Baquero-Artigao
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz, Madrid, Spain
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33
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Grasa CD, Gómez-Gil MR, San Román Pacheco S, Del Rosal T, Moreno F, Gerig N, Ochoa Fernández B, Calvo C, Baquero-Artigao F. Compassionate use of cefiderocol for VIM metallo-β-lactamase-producing Pseudomonas aeruginosa infection in a toddler with Burkitt lymphoma. J Glob Antimicrob Resist 2021; 26:91-92. [PMID: 34051403 DOI: 10.1016/j.jgar.2021.04.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/14/2021] [Accepted: 04/24/2021] [Indexed: 10/21/2022] Open
Affiliation(s)
- Carlos D Grasa
- Pediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain.
| | | | | | - Teresa Del Rosal
- Pediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain
| | - Francisco Moreno
- Pharmacy Department, Hospital Universitario La Paz, Madrid, Spain
| | - Nathalia Gerig
- Pediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain
| | | | - Cristina Calvo
- Pediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain
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Martínez-Planas A, Baquero-Artigao F, Santiago B, Fortuny C, Méndez-Echevarría A, Del Rosal T, Bustillo-Alonso M, Gale I, Guerrero C, Blázquez-Gamero D, Canet A, Lillo M, Calavia O, Núñez Cuadros E, Falcón-Neyra L, Soriano-Arandes A, Van Ingen J, Tebruegge M, Noguera-Julian A. Interferon-Gamma Release Assays Differentiate between Mycobacterium avium Complex and Tuberculous Lymphadenitis in Children. J Pediatr 2021; 236:211-218.e2. [PMID: 33984332 DOI: 10.1016/j.jpeds.2021.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/24/2021] [Accepted: 05/04/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To assess the performance of interferon-gamma release assays (IGRAs) in the differential diagnosis between Mycobacterium avium complex (MAC) and tuberculosis (TB) in children affected with subacute/chronic submandibular/cervical lymphadenitis. STUDY DESIGN Multicenter observational study comparing children with microbiologically confirmed MAC lymphadenitis from the European NontuberculouS MycoBacterial Lymphadenitis in childrEn study with children with TB lymphadenitis from the Spanish Network for the Study of Pediatric TB database. RESULTS Overall, 78 patients with MAC and 34 with TB lymphadenitis were included. Among MAC cases, 44 out of 74 (59.5%) had positive tuberculin skin test (TST) results at the 5-mm cut-off, compared with 32 out of 33 (97%) TB cases (P < .001); at the 10-mm cut-off TST results were positive in 23 out of 74 (31.1%) vs 26 out of 31 (83.9%), respectively (P < .001). IGRA results were positive in only 1 out of 32 (3.1%) patients with MAC who had undergone IGRA testing, compared with 21 out of 23 (91.3%) TB cases (P < .001). Agreement between TST and IGRA results was poor in MAC (23.3%; κ = 0.017), but good in TB cases (95.6%; κ = 0.646). IGRAs had a specificity of 96.9% (95% CI 84.3%-99.8%), positive predictive value of 95.4% (95% CI 78.2%-99.8%), and negative predictive value of 93.9% (95% CI 80.4%-98.9%) for TB lymphadenitis. CONCLUSIONS In contrast to TST, IGRAs have high specificity, negative predictive value, and positive predictive value for TB lymphadenitis in children with subacute/chronic lymphadenopathy, and consequently can help to discriminate between TB and MAC disease. Therefore, IGRAs are useful tools in the diagnostic work-up of children with lymphadenopathy, particularly when culture and polymerase chain reaction results are negative.
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Affiliation(s)
- Aina Martínez-Planas
- Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Infectious Diseases Unit, Department of Pediatrics, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Fernando Baquero-Artigao
- Pediatrics and Infectious Disease Unit, Hospital Universitario La Paz, Madrid, Spain; Fundación IdiPaz, Madrid, Spain; Translational Research Network of Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Begoña Santiago
- Translational Research Network of Pediatric Infectious Diseases (RITIP), Madrid, Spain; Department of Pediatric Infectious Diseases, University Hospital Gregorio Marañón and Gregorio Marañón Research Institute, Madrid, Spain
| | - Clàudia Fortuny
- Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Infectious Diseases Unit, Department of Pediatrics, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Translational Research Network of Pediatric Infectious Diseases (RITIP), Madrid, Spain; Center for Biomedical Network Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Pediatrics, University of Barcelona, Barcelona, Spain
| | - Ana Méndez-Echevarría
- Pediatrics and Infectious Disease Unit, Hospital Universitario La Paz, Madrid, Spain; Fundación IdiPaz, Madrid, Spain; Translational Research Network of Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Teresa Del Rosal
- Pediatrics and Infectious Disease Unit, Hospital Universitario La Paz, Madrid, Spain; Fundación IdiPaz, Madrid, Spain; Translational Research Network of Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | | | - Inés Gale
- Pediatrics Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Carmelo Guerrero
- Pediatrics Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Daniel Blázquez-Gamero
- Translational Research Network of Pediatric Infectious Diseases (RITIP), Madrid, Spain; Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain; Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Sanitaria Hospital 12 de Octubre (IMAS12), Madrid, Spain; Fundación para la Investigación Biomédica del Hospital 12 de Octubre, Madrid, Spain
| | - Anna Canet
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Miguel Lillo
- Pediatrics Department, Hospital General Universitario de Albacete, Albacete, Spain
| | - Olga Calavia
- Pediatrics Department, Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Esmeralda Núñez Cuadros
- Division of Pediatric Rheumatology, Hospital Regional Universitario Materno-Infantil de Málaga, Málaga, Spain
| | - Lola Falcón-Neyra
- Pediatric Infectious Diseases, Rheumatology and Immunology Unit, Hospital Universitario Virgen del Rocío, Institute of Biomedicine, Seville, Spain
| | - Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Hospital Universitari, Barcelona, Spain; Infection in the Immunocompromissed Child Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Jakko Van Ingen
- Radboudumc Center for Infectious Diseases, Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marc Tebruegge
- Department of Paediatric Infectious Diseases and Immunology, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom; Department of Pediatrics, The University of Melbourne, Parkville, Australia; Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Antoni Noguera-Julian
- Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Infectious Diseases Unit, Department of Pediatrics, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Translational Research Network of Pediatric Infectious Diseases (RITIP), Madrid, Spain; Center for Biomedical Network Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Pediatrics, University of Barcelona, Barcelona, Spain.
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Vázquez-Pérez Á, Alonso-Acero L, Baquero-Artigao F, de Pablos Gómez M, Calvo C. [Community-acquired urinary tract infections: Etiological, resistance and patient's profile at a tertiary hospital]. An Pediatr (Barc) 2021; 96:S1695-4033(21)00232-0. [PMID: 34340941 DOI: 10.1016/j.anpedi.2021.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/06/2021] [Accepted: 06/14/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Álvaro Vázquez-Pérez
- Servicio de Pediatría y Enfermedades Infecciosas Pediátricas, Hospital Universitario La Paz, Madrid, España.
| | - Laura Alonso-Acero
- Servicio de Microbiología, Hospital Universitario La Paz, Madrid, España
| | - Fernando Baquero-Artigao
- Servicio de Pediatría y Enfermedades Infecciosas Pediátricas, Hospital Universitario La Paz, Madrid, España
| | | | - Cristina Calvo
- Servicio de Pediatría y Enfermedades Infecciosas Pediátricas, Hospital Universitario La Paz, Madrid, España
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Cendejas-Bueno E, Peinado H, Baquero-Artigao F, Falces-Romero I, Calvo-Rey C, Banda-Montalvo LL, García-Rodríguez J. Off-label use of T2Candida ® test in vitreous humor for diagnosing invasive candidiasis: a clinical report. Future Microbiol 2021; 16:619-621. [PMID: 34082566 DOI: 10.2217/fmb-2020-0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Here, we present a case of off-label successful use of the T2 MR (T2Candida® test) for the diagnosis of invasive candidiasis (Candida albicans endolphthalmitis). This case demonstrates that T2Candida could be performed in sterile body fluids to improve microbiological diagnosis of invasive candidiasis.
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Affiliation(s)
- Emilio Cendejas-Bueno
- Department of Clinical Microbiology, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Helena Peinado
- Department of Neonatology, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Fernando Baquero-Artigao
- Department of Pediatric Infectious & Tropical Diseases, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Iker Falces-Romero
- Department of Clinical Microbiology, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Cristina Calvo-Rey
- Department of Pediatric Infectious & Tropical Diseases, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Leticia La Banda-Montalvo
- Department of Neonatology, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Julio García-Rodríguez
- Department of Clinical Microbiology, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain
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Aguilera-Alonso D, Martínez Campos L, Fernández Llamazares CM, Calvo C, Baquero-Artigao F. [New antibiotic susceptibility testing definitions: «I» no longer means intermediate susceptibility]. An Pediatr (Barc) 2021; 96:S1695-4033(21)00182-X. [PMID: 34074616 DOI: 10.1016/j.anpedi.2021.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- David Aguilera-Alonso
- Sección de Enfermedades Infecciosas, Servicio de Pediatría, Instituto de Investigación Sanitaria, Hospital General Universitario Gregorio Marañón, Sociedad Española de Infectología Pediátrica (SEIP), Red de Investigación Traslacional en Infectología Pediátrica (RITIP), Madrid, España.
| | - Leticia Martínez Campos
- Servicio de Pediatría, Hospital Torrecárdenas, Sociedad Española de Infectología Pediátrica (SEIP), Almería, España
| | - Cecilia M Fernández Llamazares
- Servicio de Farmacia, Hospital General Universitario Gregorio Marañón. Sociedad Española de Farmacia Hospitalaria (SEFH), Madrid, España
| | - Cristina Calvo
- Servicio de Pediatría, Enfermedades Infecciosas y Patología Tropical, Hospital La Paz, Sociedad Española de Infectología Pediátrica (SEIP), Red de Investigación Traslacional en Infectología Pediátrica (RITIP), Madrid, España
| | - Fernando Baquero-Artigao
- Servicio de Pediatría, Enfermedades Infecciosas y Patología Tropical, Hospital La Paz, Sociedad Española de Infectología Pediátrica (SEIP), Red de Investigación Traslacional en Infectología Pediátrica (RITIP), Madrid, España
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Dorado Criado M, Fabra Garrido C, Buitrago Gil C, Baquero-Artigao F. Neumonitis por Chlamydia trachomatis: una enfermedad infradiagnosticada y potencialmente grave. Enferm Infecc Microbiol Clin 2021; 39:265-266. [DOI: 10.1016/j.eimc.2020.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
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Santos-Pérez JL, Delgado-Mainar P, Toro-Rueda C, Baquero-Artigao F. Infección de herida quirúrgica por Mycobacterium senegalense en paciente pediátrico. Enferm Infecc Microbiol Clin 2021; 39:259-261. [DOI: 10.1016/j.eimc.2020.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 08/05/2020] [Accepted: 08/09/2020] [Indexed: 11/29/2022]
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López López S, Del Rosal T, Jiménez Bueno S, Baquero-Artigao F. Septicemia and meningitis associated with Haemophilus influenzae type b vaccine failure. Enferm Infecc Microbiol Clin 2020; 39:S0213-005X(20)30319-0. [PMID: 33176908 DOI: 10.1016/j.eimc.2020.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Sara López López
- Servicio de Pediatría. Complejo Hospitalario Universitario Insular Materno Infantil de Canarias, Las Palmas de Gran Canaria, Gran Canaria, España
| | - Teresa Del Rosal
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz, Madrid, España.
| | | | - Fernando Baquero-Artigao
- Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz, Madrid, España
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Escosa-García L, Aguilera-Alonso D, Calvo C, Mellado MJ, Baquero-Artigao F. Ten key points about COVID-19 in children: The shadows on the wall. Pediatr Pulmonol 2020; 55:2576-2586. [PMID: 32790245 PMCID: PMC7436376 DOI: 10.1002/ppul.25025] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/10/2020] [Indexed: 01/08/2023]
Abstract
The pandemic of the new coronavirus disease-2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), initially described in China, is challenging the health care systems of all countries. Every emerging disease raises many questions with a scarcity of answers since all its characteristics are still being discovered. In the case of SARS-CoV-2, most of the literature comes from adult patients. Children seem to be less affected. Pediatric patients diagnosed with COVID-19 disease usually suffer a mild illness, with a low risk of complications, or mortality. Defining the role of children in the transmission of SARS-CoV-2 is critical as some national infection control decisions involving children, such as school closures or social distancing, will probably impact the dynamics of the virus. To aid in the knowledge of COVID-19 in children, this study presents an expert review of the literature published from 1 January to 28 May 2020, including peer-reviewed and preprint nonpeer-reviewed studies, along with some relevant articles afterward, summarizing ten key points that characterize the disease in children.
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Affiliation(s)
- Luis Escosa-García
- Department of Pediatrics, Infectious, and Tropical Diseases, La Paz Hospital, The Translational Research Network of Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - David Aguilera-Alonso
- Department of Pediatrics, Pediatric Infectious Diseases Unit, Gregorio Marañón Hospital, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), The Translational Research Network of Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Cristina Calvo
- Department of Pediatrics, Infectious, and Tropical Diseases, La Paz Hospital, The Translational Research Network of Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - María José Mellado
- Department of Pediatrics, Infectious, and Tropical Diseases, La Paz Hospital, The Translational Research Network of Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Fernando Baquero-Artigao
- Department of Pediatrics, Infectious, and Tropical Diseases, La Paz Hospital, The Translational Research Network of Pediatric Infectious Diseases (RITIP), Madrid, Spain
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42
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De la Calle M, Baquero-Artigao F, Rodríguez-Molino P, Cabanes M, Cabrera M, Antolin E, Mellado MJ, Bartha JL. Combined treatment with immunoglobulin and valaciclovir in pregnant women with cytomegalovirus infection and high risk of symptomatic fetal disease. J Matern Fetal Neonatal Med 2020; 35:3196-3200. [PMID: 32933353 DOI: 10.1080/14767058.2020.1815188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Congenital cytomegalovirus (CMV) infection is one of the most common during pregnancy. The infection, particularly in the first trimester, is associated with important sequelae in up to half of the children. Valaciclovir and immunoglobulin have been tested separately for the treatment of fetal CMV infection with relative success. Nevertheless, there is no experience with the simultaneous use of both therapies. METHODS combination therapy (oral valaciclovir 2 g/6h until the end of pregnancy and intravenous hyperimmune gamma globulin 200 UI/kg) was offered to pregnant women with CMV infection acquired during pregnancy and viral load (VL) in amniotic fluid above 105 copies/ml and/or brain injuries in the ultrasonography. Additional immunoglobulin monthly doses were used in case of ultrasonography or MRI evidence of persistent fetal involvement. Neurological and hearing evaluations of infants were performed at birth and every 3 months during follow-up. RESULTS 15 pregnant women were enrolled: primary infection, 14, non-primary infection, 1; first trimester, 11, second trimester, 4. Mean gestational age at the start of combination treatment were 23.2 weeks and 29.3 weeks, depending on the infection being diagnosed in the first or the second trimester, respectively. Median VL of CMV-DNA in amniotic fluid was 62.5 × 105 copies/ml. Intrauterine progression of fetal brain lesions was only observed in two cases in which the dose of CMV-HIG was repeated, slowing their progression. Although the treatment has failed to reverse ultrasound fetal lesions, only 3 children were born with hearing impairment and their psychomotor development was consistent with chronological age in all patients but one. Combination therapy was not associated with adverse effects in either the mothers or the fetuses. CONCLUSION Combination therapy with immunoglobulin and valaciclovir may be a useful alternative in CMV fetal infection, particularly if changes in cerebral echography or high VL in the amniotic fluid are present.
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Affiliation(s)
- Maria De la Calle
- Department of Obstetrics and Gynaecology, Maternal-Fetal Medicine Unit, La Paz University Hospital, Madrid, Spain
| | | | | | - Maria Cabanes
- Department of Obstetrics and Gynaecology, Maternal-Fetal Medicine Unit, La Paz University Hospital, Madrid, Spain
| | - Marta Cabrera
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
| | - Eugenia Antolin
- Department of Obstetrics and Gynaecology, Maternal-Fetal Medicine Unit, La Paz University Hospital, Madrid, Spain
| | - Maria José Mellado
- Department of Pediatric Infectology, La Paz University Hospital, Madrid, Spain
| | - José Luis Bartha
- Department of Obstetrics and Gynaecology, Maternal-Fetal Medicine Unit, La Paz University Hospital, Madrid, Spain
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Piñeiro Pérez R, Álvez González F, Baquero-Artigao F, Cruz Cañete M, de la Flor i Bru J, Fernández Landaluce A, García Vera C, Hijano Bandera F, Pérez Cánovas C, Silva Rico JC, Alfayate Miguélez S, Ares Álvarez J, Berghezan Suárez A, Borrull Senra AM, Cabrera Roca G, Calvo Rey C, Carazo Gallego B, Cilleruelo Ortega MJ, Conejo Fernández A, López Ávila J, Lupiani Castellanos P, Martínez Campos L, Sotoca Fernández J. Actualización del documento de consenso sobre el diagnóstico y tratamiento de la faringoamigdalitis aguda. An Pediatr (Barc) 2020; 93:206.e1-206.e8. [DOI: 10.1016/j.anpedi.2020.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/05/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022] Open
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García-Boyano M, Caballero-Caballero JM, Fernández-Menéndez A, Baquero-Artigao F. Title of the manuscript: Chylothorax in a 4-year-old boy with trisomy 21. Pediatr Pulmonol 2020; 55:2187-2188. [PMID: 32483889 DOI: 10.1002/ppul.24868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/21/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Miguel García-Boyano
- Pediatric Infectious Disease Department, Hospital Universitario La Paz, Madrid, Spain
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Soler-Garcia A, Gamell A, Santiago B, Monsonís M, Calvo C, Cobo E, Colino E, Espiau M, Guerrero-Laleona C, Lobato Z, Martín-Nalda A, Pérez-Gorricho B, Perez-Porcuna TM, Piqueras AI, Rodríguez-Molino P, Ruiz M, Soriano-Arandes A, Valmanya T, Tebruegge M, Noguera-Julian A, Gómez-Pastrana D, Montero M, Peromingo E, Bustillo M, Moliner E, Fenoy M, Velásquez M, Soler MQ, GARCÍA L, Calavia O, Rius N, Pascual MT, Soler-Palacín P, Tórtola T, Lillo M, Dapena M, López-Medina EM, Ruiz M, Santos MDM, Hernández Á, Hernández-Sanpelayo T, Tagarro A, Méndez A, Mellado MJ, Baquero-Artigao F, Sainz T, García-Hortelano M, Álvarez J, Villalobos E, García-García ML, Garrote MI, Korta Murua JJ, Gundín NA, Sánchez-Torrent L, Velasco-Arnaiz E, Fortuny C. Diagnostic Accuracy of QuantiFERON-TB Gold Plus Assays in Children and Adolescents with Tuberculosis Disease. J Pediatr 2020; 223:212-215.e1. [PMID: 32334890 DOI: 10.1016/j.jpeds.2020.02.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/27/2020] [Accepted: 02/12/2020] [Indexed: 10/24/2022]
Abstract
In 2016, a new interferon-gamma release assay, QuantiFERON-TB Gold Plus, was introduced. We conducted a cross-sectional multicenter study, involving 158 children and adolescents with tuberculosis disease. The overall sensitivity of the assay was 82.9% (IQR 77.0%-88.8%), indicating that in children this test does not have higher sensitivity than previous generation interferon-gamma release assays.
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Affiliation(s)
- Aleix Soler-Garcia
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d´Infeccions, Servei de Pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - Anna Gamell
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d´Infeccions, Servei de Pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain
| | - Begoña Santiago
- Pediatric Infectious Diseases Unit, Gregorio Marañón Hospital, Madrid, Spain
| | - Manuel Monsonís
- Servei de Microbiologia, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Cristina Calvo
- Pediatrics Department, Hospital Severo Ochoa, Madrid, Spain; Pediatric Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain; Health Research Institute IdiPAZ, Hospital La Paz, Madrid, Spain; Red de Investigación Translacional en Infectología Pediátrica, RITIP, Madrid, Spain
| | - Elvira Cobo
- Pediatric Infectious Diseases Unit, Gregorio Marañón Hospital, Madrid, Spain
| | - Elena Colino
- Pediatrics Department, Complejo Hospitalario Universitario Insular-Materno Infantil de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - María Espiau
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Carmelo Guerrero-Laleona
- Unidad de Enfermedades Infecciosas, Servicio de Pediatría, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Zulema Lobato
- Servei de Pediatria, Hospital Sant Joan de Déu, Fundació Althaia, Manresa, Spain
| | - Andrea Martín-Nalda
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Beatriz Pérez-Gorricho
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Tomas M Perez-Porcuna
- Atenció Primària, Fundació Assistencial Mútua Terrassa, Terrassa, Spain; Unitat de Salut Internacional, Departament de Pediatria, Fundació Recerca Mútua Terrassa, Atenció Primària, Hospital Universitari Mútua de Terrassa, Universitat de Barcelona, Terrassa, Spain
| | - Ana Isabel Piqueras
- Pediatric Infectious Diseases Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Marta Ruiz
- Pediatrics Department, Hospital de Getafe, Madrid, Spain
| | - Antoni Soriano-Arandes
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Teresa Valmanya
- Servei de Pediatria, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Marc Tebruegge
- Department of Pediatric Infectious Diseases & Immunology, Evelina London Childrenś Hospital, Guyś and St. Thomaś NHS Foundation Trust, London, United Kingdom; Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom; Department of Pediatrics, University of Melbourne, Parkville, Australia
| | - Antoni Noguera-Julian
- Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d´Infeccions, Servei de Pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain; Red de Investigación Translacional en Infectología Pediátrica, RITIP, Madrid, Spain; Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.
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de Ceano-Vivas M, Martín-Espín I, del Rosal T, Bueno-Barriocanal M, Plata-Gallardo M, Ruiz-Domínguez JA, López-López R, Molina-Gutiérrez MÁ, Bote-Gascón P, González-Bertolín I, García-Sánchez P, Martín-Sánchez J, de Miguel-Lavisier B, Sainz T, Baquero-Artigao F, Méndez-Echevarría A, Calvo C. SARS-CoV-2 infection in ambulatory and hospitalised Spanish children. Arch Dis Child 2020; 105:808-809. [PMID: 32444450 PMCID: PMC7392480 DOI: 10.1136/archdischild-2020-319366] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2020] [Indexed: 01/28/2023]
Affiliation(s)
| | - Irene Martín-Espín
- Paediatric Emergency Department, Hospital Universitario La Paz, Madrid, Spain
| | - Teresa del Rosal
- Paediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain,Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | | | | | | | - Rosario López-López
- Paediatric Emergency Department, Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | | | | | | | - Talía Sainz
- Paediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain,Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Fernando Baquero-Artigao
- Paediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain,Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Ana Méndez-Echevarría
- Paediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain,Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
| | - Cristina Calvo
- Paediatric Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain,Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain
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García-Boyano M, Caballero-Caballero JM, Alguacil-Guillén M, Baquero-Artigao F. Acute encephalopathy with biphasic seizures and late reduced diffusion in a Spanish girl. Brain Dev 2020; 42:307-310. [PMID: 31992519 DOI: 10.1016/j.braindev.2019.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/22/2019] [Accepted: 12/03/2019] [Indexed: 11/29/2022]
Abstract
We report a case of a 22-month-old Spanish girl who presented acute encephalopathy with biphasic seizures and late reduced diffusion (AESD). Serum procalcitonin (PCT) reached a maximum of 50.5 ng/mL on the first day whereas C-reactive protein (CRP) peaked at 1.21 mg/dL on the second. At the time of discharge, right spastic hemiparesis persisted. MR spectroscopy on day 23 revealed a decrease in N-acetylaspartate and an increase in choline. To our knowledge, we report the first case of AESD in Europe. These findings support the role of PCT and PCT/CRP ratio in the early diagnosis of AESD and correlation of MR spectroscopy findings with neurological outcome.
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Piñeiro Pérez R, Martínez Campos L, Cilleruelo Ortega MJ, Piñeiro Pérez R, José Cilleruelo Ortega M, Ares Álvarez J, Baquero-Artigao F, Carlos Silva Rico J, Velasco Zuñiga R, Martínez Campos L, Carazo Gallego B, José Conejo Fernández A, Calvo Rey C, Alfayate Miguélez S, Berghezan Suárez A, García Vera C, José García García J, Herreros Fernández M, Rodrigo Gonzalo de Liria C. «Recomendaciones sobre el diagnóstico y tratamiento de la infección urinaria», respuesta de los autores. An Pediatr (Barc) 2020; 92:184-186. [DOI: 10.1016/j.anpedi.2019.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 12/27/2019] [Indexed: 01/05/2023] Open
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49
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Del Rosal T, Caminoa MB, González-Guerrero A, Falces-Romero I, Romero-Gómez MP, Baquero-Artigao F, Sainz T, Méndez-Echevarría A, Escosa-García L, Aracil FJ, Calvo C. Outcome of Severe Bacterial Pneumonia in the Era of Pneumococcal Vaccination. Front Pediatr 2020; 8:576519. [PMID: 33384973 PMCID: PMC7769833 DOI: 10.3389/fped.2020.576519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 11/27/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: After the introduction of pneumococcal conjugate vaccines, community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae has decreased whereas Staphylococcus aureus and Streptococcus pyogenes could be increasing. These bacteria have been associated with high rates of complications. Aims: (1) To describe the characteristics of pediatric bacterial CAP requiring hospitalization. (2) To compare outcomes according to causative microorganisms. (3) To analyze changes in bacterial CAP rate and etiology over time. Patients and Methods: Retrospective single-center study of inpatients aged 1 month-16 years with culture-confirmed bacterial CAP in 2010-2018 in Madrid, Spain. Results: We included 64 cases (42 S. pneumoniae, 13 S. pyogenes and 9 S. aureus). Culture-confirmed CAP represented 1.48-2.33/1,000 all-cause pediatric hospital admissions, and its rate did not vary over time. However, there was a significant decrease in pneumococcal CAP in the last 3 years of the study (78% of CAP in 2010-2015 vs. 48% in 2016-18, p = 0.017). Median hospital stay was 10.5 days (interquartile range 5-19.5), 38 patients (59%) developed complications and 28 (44%) were admitted to the intensive care unit. Outcomes were similar among children with S. pneumoniae and S. aureus CAP, whereas S. pyogenes was associated with a higher risk for complications (OR 8 [95%CI 1.1-57.2]) and ICU admission (OR 7.1 [95%CI 1.7-29.1]) compared with pneumococcal CAP. Conclusion: In a setting with high PCV coverage, culture-confirmed bacterial CAP did not decrease over time and there was a relative increase of S. pyogenes and S. aureus. Children with CAP caused by S. pyogenes were more likely to develop complications.
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Affiliation(s)
- Teresa Del Rosal
- Department of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, Spain
| | | | - Alba González-Guerrero
- Department of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, Spain
| | - Iker Falces-Romero
- Department of Microbiology, Hospital Universitario La Paz, Madrid, Spain
| | | | - Fernando Baquero-Artigao
- Department of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, Spain
| | - Talía Sainz
- Department of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, Spain.,Red de Investigación Traslacional en Infectología Pediátrica, Madrid, Spain
| | - Ana Méndez-Echevarría
- Department of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, Spain
| | - Luis Escosa-García
- Department of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, Spain
| | - Francisco Javier Aracil
- Department of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, Spain
| | - Cristina Calvo
- Department of Pediatric Infectious Diseases, Hospital Universitario La Paz and IdiPAZ Research Institute, Madrid, Spain.,Red de Investigación Traslacional en Infectología Pediátrica, Madrid, Spain
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50
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Martínez Rodríguez E, Lorenzino L, Baquero-Artigao F, Calvo C. [Need for surgery in paediatric deep abcesses of the neck]. An Pediatr (Barc) 2019; 92:389-390. [PMID: 31864846 DOI: 10.1016/j.anpedi.2019.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/27/2019] [Indexed: 10/25/2022] Open
Affiliation(s)
- Eduardo Martínez Rodríguez
- Servicio de Pediatría y Enfermedades Infecciosas Pediátricas, Hospital Universitario La Paz, Madrid, España.
| | - Lucía Lorenzino
- Servicio de Pediatría y Enfermedades Infecciosas Pediátricas, Hospital Universitario La Paz, Madrid, España
| | - Fernando Baquero-Artigao
- Servicio de Pediatría y Enfermedades Infecciosas Pediátricas, Hospital Universitario La Paz, Madrid, España; Fundación IdiPaz, Madrid, España; Red de Investigación Traslacional en Infectología Pediátrica (RITIP)
| | - Cristina Calvo
- Servicio de Pediatría y Enfermedades Infecciosas Pediátricas, Hospital Universitario La Paz, Madrid, España; Fundación IdiPaz, Madrid, España; Red de Investigación Traslacional en Infectología Pediátrica (RITIP); TEDDY Network (European Network of Excellence for Pediatric Clinical Research)
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