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Objective: The objective of this study was to determine the epidemiology of Mycoplasma pneumoniae infections at our hospital and to evaluate the prescription of macrolides to empirically treat respiratory infections in children., Patients and Methods: A one year prospective study was performed. To find out the prevalence of M. pneumoniae infections, we obtained blood samples of 519 children attending our hospital out-patient department to determine M. pneumoniae IgG levels. In order to establish the incidence, IgM antibodies against M. pneumoniae were measured in 255 children admitted to the hospital showing clinical pictures compatible with this infection., Results: In the first years of life, prevalence of M. pneumoniae infection was low. According to our study, only 3.3% of 1 year-old patients had M. pneumoniae antibodies. Antibody levels increased in children of 5 years or older. The highest rates, between 58.5% and 63.3%, were detected in patients between 8 and 12 years of age. The incidence rate (6.7%) was low among the children admitted. The most frequent clinical entity was pneumonia (82%). The highest rate of infection was found in children of 8 to 10 years. Symtomatology was mainly sub-acute. Crioagglutinins provided the most significant predictive value for etiological diagnosis., Conclusions: M. pneumoniae infections gain significance in patients over 5 years of age. In our environment, incidence of acute symptomatic infection is low. We consider that both age and presentation of acute respiratory processes should be taken into account when establishing empirical macrolide treatment in children.

Objective: Since its casual discovery and implication as a human pathogen that provokes transitory aplastic crises and infectious erythema, the B19 parvovirus has been related to a wide spectrum of diseases. To better understand this clinical diversity, we reviewed the cases of a serology positive infants admitted to the hospital., Patients and Methods: From January 1992 to June 1995, all clinical charts were reviewed and we obtained 15 patients that had positive IgM antibodies by immunoenzyme assay., Results: The mean age was 12.2 months. No sex differences were seen. The incidence was higher in winter months. Over 50% of the patients belong to the last year studied. Clinical findings included 5 cases of arthritis (one juvenile rheumatoid arthritis, one polyarticular syndrome and 3 nonspecific forms), hematology disturbances in 5 cases (1 case of erythrophagocytosis, 1 of thrombocytopenic purpura, 2 of anemia and 1 chronic neutropenia), 3 cases of febrile syndrome, 1 liver dysfunction, and 1 neuromyelitis. Complementary exams were not significant and follow-up in all infants was satisfactory., Conclusions: The B19 parvovirus, a poorly understood virus, is related to many clinical situations where is true significance remains unknown.

Objective: The purpose of this study was to study the epidemiology of invasive childhood pneumococcal infection in our hospital., Patients and Methods: The records of all children attending our hospital from whom Streptococcus pneumoniae was isolated from the blood or CSF were reviewed. Serotyping and MIC were performed at C.N.M.V.S. (Majadahonda)., Results: Seventy-one pneumococci were isolated in 70 patients. The annual incidence increased from 0.14% to 0.40%. The clinical entities were: bacteremia without focus (45%), pneumonia (29.6%), meningitis (12.7%), cellulitis (5.6%), mastoiditis (5.6%) and endocarditis (1.4%). The age of 72% of the patients was less than 3 years. In 26.8% of the cases, the patient had an underlying disease and/or was previously hospitalized. The antibiotic susceptibility pattern was: penicillin (MIC < or = 0.06 microgram/ml) 45.7%, cefotaxime (MIC < or = 0.5 microgram/ml) 82.8% and erythromycin (MIC < or = 0.5 microgram/ml) 70%. Penicillin resistance of the isolated pneumococci was more often present in the group with risk factors than in those without such risk factors (p < 0.05). There were 13 different serotypes, the most prevalent were 6 (23%), 19 (17%), 14 (14%) and 23 (12%) and the most frequently penicillin-resistant (Resistant N(o)/Total N(o) were: 6 (15/15), 9 (4/4), 14 (8/9) and 23 (6/8)., Conclusions: Streptococcus pneumoniae is a common cause of invasive infections in children in our hospital. There was a high prevalence of serotype 6 (penicillin-resistant) as compared to in adults where serotype 3 (penicillin-susceptible) is the most prevalent. A higher rate of antibiotic resistant strains associated with risk factors (underlying disease or nosocomial acquisition), probably related to prior antibiotic use, was observed.

Forty-six children seen during 1989 with the clinical diagnosis of Pertussis are reviewed in this study. In 64.5% of the cases the Bordet-Gengou medium nasopharyngeal culture was positive for B. pertussis. Two age groups showed more susceptibility to B. pertussis, children under one year of age (70%) and of more than five years of age (20%). The disease was of more severity among infants younger than two months of age (apnea, choking spells, etc.). Most infants needed to be admitted to the hospital. All patients received therapy with erythromycin, salbutamol (80%) and general supportive medical care. No deaths or other medical sequelae were observed.

The cases of tuberculosis in the Pediatric Units of the Basque Autonomous Community during the period of 1980-89 were studied. The annual incidence rate in the 0-4 year old age group was 5.8 per 100.00 in Biscay (95% confidence interval: 4.0-7.6), 5.9 (2.3-9.5) in Alava and 16.7 (12.7-20.7) in Guipúzcoa. Out of the 263 registered cases, 55 (21%) corresponded to meningitis and/or miliaria, 194 (74%) to respiratory tuberculosis and 14 (5%) to other clinical forms. Of these cases, the diagnosis in 83 (32%) was based on results from microbiological cultures, in 8 (3%) on histological examinations and in the remaining 172 (65%) on other diagnostic criteria. In 226 cases (86%) no scars were found nor were there any antecedents of BCG vaccination. In 32 patients (12%), there were scars or antecedents of BCG vaccinations and in 5 cases no information was available. The estimated protective effect of the BCG vaccination in the 0-4 year old group was 88% and in the 5-14 year old group 63%. We recommend that the efficiency of the BCG vaccination program be studied in order to assess the need of this program.

Authors present a prospective study upon 193 cases of acute gastroenteritis in infants 1 to 24 months of age, giving special attention to clinical evolution of the disease without any use of therapy of either antibiotics or other antidiarrheal agents. Data on epidemiology and etiology of this series are similar to those previously reported by other authors. Mean duration of diarrhea was 2,5 days, whereas mean hospital stay was 7,5 days. The number of cases of prolonged diarrhea was 13, from which six were cases of lactose intolerance, six were cases of cow's milk protein intolerance and one was a case of intractable diarrhea. The little use fulness of antibiotics in the treatment of acute diarrhea is commented and also a discussion is made of the different factors involved in the onset of the complications above mentioned.