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1. Evaluación del impacto del Documento de Consenso español sobre el abordaje de las infecciones osteoarticulares en nuestro medio a través de la Red de Infecciones Osteoarticulares Pediátricas (RIOPed)

Author

Esmeralda Núñez Cuadros, Cristina Calvo Rey, Jesús Saavedra-Lozano, Rosa Alcobendas Rueda, Daniel Clemente Garulo, F. José Sanz Santaeufemia, Leticia Martínez Campos, Alfredo Tagarro García, César G. Fontecha, Susana Melendo-Pérez, Marisol Camacho Lovillo, Lola Falcón Neyra, M. José Lirola Cruz, Elena Colino Gil, Patricia Tejera Carreño, Luis Mayol Canals, Daniel Domenech Zarketa, M. Mercedes Bueno Campaña, Carlos Pérez Méndez, Neus Rius Gordillo, Verónica Cardona, Jaime Carrasco Colom, Antonio Conejo Fernández, Marta García Ramírez, Rafael Díez Delgado, Carmen Vázquez Ordónez, Enrique Otheo de Tejada, José Couceiro Gianzo, Leonor Arranz, Carmen García-Pardos, Roi Piñeiro-Pérez, Beatriz Bravo Mancheño, Inmaculada López-Molina, Adriana Vidal Acevedo, María Penín Antón, M. Teresa Coll, Berta Pujol Soler, Pilar Ranchal Pérez, Sara Pons Morales, Belén Sevilla, María Méndez Hernández, M. Jesús García-Mazarío, César Gavilán Martín, Elisa Fernández-Cooke, Anna Canet, Marta Ruiz Jiménez, Marina González, Lourdes García Rodríguez, Carmen Moreno, Miren Oscoz Lizarbe, Laura Martín-Pedraz, Miguel Lillo Lillo, Antonio J. Cepillo, Pere Soler-Palacín, Jan Ramakers, Olga Calavia Gasaball, Rebeca Lahoz Ramo, Pedro Terol Barrero, M. José Muñoz Vilchez, Victoria Fumadó Pérez, Silvia Urraca Camps, Elena Urbaneja Rodríguez, M. José Cilleruelo Ortega, Agustín López López, Valentín Pineda Solas, Carla Monterde Pedrab, Rosa Roldán Molina, Sandra Masegosa-Casanova, Paula Alcañiz Rodríguez, Ana Menasalvas Ruíz, Javier Arístegui-Fernández, Elisa Garrote, Federico Martinón-Torres, Irene Rivero-Calle, José Tomás Ramos, Marta Illán Ramos, Beatriz Jiménez Montero, Begoña Losada Pinedo, Borja Guarch Ibáñez, Marcelina Algar Serrano, M. Dolores García, Elena Pereira, Silvia Rodríguez-Blanco, Manuel Muñiz Fontán, Sagrario Bustabab Reyes, Antonio Medina Claros, Isabel Vives Oñós, M. Concepción Mir Perelló, Natalia Cerdeira Barreiro, María Ríos Barnés, Isabel Vara Patudo, Soledad Martínez-Regueira, Raquel Marín Domenech, Juan Salvador Vílchez, Jesús de la Cruz Moreno, Carmelo Guerrero Laleona, Matilde Bustillo Alonso, Leticia Merino Meléndez, and Azucena García Martín

Subjects
Osteoarticular infections, Osteomyelitis, Septic arthritis, Diagnosis, Treatment, Pediatrics, RJ1-570
Abstract

Resumen: Introducción: En 2014 se publicó el Documento de Consenso desarrollado por SEIP-SERPE-SEOP para el diagnóstico y el tratamiento de las infecciones osteoarticulares (IOA). En 2015 se constituyó RIOPed como red nacional multidisciplinar para la investigación en IOA. El objetivo del estudio ha sido valorar el grado de adecuación a las recomendaciones establecidas en el consenso durante un año de seguimiento. Material y métodos: Estudio prospectivo multicéntrico nacional realizado entre septiembre de 2015 y septiembre de 2016 en 37 hospitales con inclusión de pacientes menores de 16 años diagnosticados de IOA, confirmada mediante aislamiento microbiológico, o probable: artritis séptica (AS) con > 40.000 leucocitos en líquido sinovial u osteomielitis (OM)/osteoartritis (OA)/espondilodiscitis (ED) con prueba de imagen compatible. Los resultados se compararon con los obtenidos en el estudio retrospectivo realizado entre 2008 y 2012. Resultados: Se incluyeron 255 casos: 131 OM, 79 AS, 30 OA y 15 ED. Respecto a las pruebas complementarias que el consenso consideró de obligada realización, la radiografía se llevó a cabo en el 87,8% de los casos, el hemocultivo en el 91,6% y el cultivo de líquido sinovial en el 99% de AS. Se realizó RM en el 71% de las OM. La elección del tratamiento antibiótico intravenoso empírico se adecuó a las recomendaciones en el 65,1% de los casos, y en el 62,3% para el tratamiento oral. Se llevó a cabo cirugía en el 36,8% de las AS (85,7% artrotomía), con un descenso significativo respecto al estudio retrospectivo (p = 0,014). Solo el 58,5% de casos se ajustaron a las recomendaciones de duración del tratamiento; sin embargo, se comprobó una menor duración del tratamiento intravenoso. Conclusiones: En general, el grado de adecuación a las recomendaciones que marcaron el grupo de expertos es bueno para las pruebas complementarias y aceptable respecto a la elección del tratamiento antibiótico, aun detectándose casi un 40% de inadecuación. Se ha conseguido un descenso de la estancia hospitalaria. Abstract: Introduction: In 2014 the Consensus Document produced by the Spanish Paediatric Societies (SEIP-SERPE-SEOP) was published to help in the diagnosis and treatment of osteoarticular infections (OAI). In 2015 the RIOPed was considered as a multidisciplinary national network for the investigation into OAI. The aim of this study was to assess the level of adaption to the recommendations established in the Consensus during one year of follow-up. Material and methods: A prospective, national multicentre study was carried out in 37 hospitals between September 2015 and September 2016. The study included patients > 16 years-old with a diagnosis of OAI, confirmed by microbiological isolation, or probable: septic arthritis (SA) with > 40,000 white cells in synovial fluid, or osteomyelitis (OM)/spondylodiscitis (SD) with a compatible imaging test. The results were compared with those obtained in a retrospective study conducted between 2008 and 2012. Results: A total of 235 cases were included, of which 131 were OM, 79 SA, 30 OA, and 15 SD. As regards the complementary tests that the Consensus considered mandatory to perform, radiography was carried out on 87.8% of the cases, a blood culture on 91.6%, and culture of the synovial fluid in 99% of SA. A magnetic resonance (MR) was performed on 71% of the OM cases. The choice of intravenous empirical antibiotic treatment was adapted to the recommendations in 65.1% of cases, and in 62.3% for the oral treatment. Surgery was performed in 36.8% of SA cases (85.7% arthrotomy), with a significant decrease compared to the retrospective study (P = .014). Only 58.5% of cases followed the recommendations on the duration of the treatment; however, a lower duration of intravenous treatment was observed. Conclusions: In general, the level of adaptation to the recommendations that were set by the Expert Group, is good for the complementary tests, and acceptable as regards the choice of antibiotic treatment, although inadequate in almost 40% of cases. A decrease in hospital stay was achieved.

Published
2020
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2. Evaluation of the impact of the Spanish Consensus Document on the approach to osteoarticular infections in Spain through the Paediatrics Osteoarticular Infections Network (RIOPED)

Author

Esmeralda Núñez Cuadros, Cristina Calvo, Jesús Saavedra-Lozano, Rosa Alcobendas Rueda, Daniel Clemente Garulo, F. José Sanz Santaeufemia, Leticia Martínez Campos, Alfredo Tagarro García, César G. Fontecha, Susana Melendo-Pérez, Marisol Camacho Lovillo, Lola Falcón Neyra, M. José Lirola Cruz, Elena Colino Gil, Patricia Tejera Carreño, Luis Mayol Canals, Daniel Domenech Zarketa, M. Mercedes Bueno Campaña, Carlos Pérez Méndez, Neus Rius Gordillo, Verónica Cardona, Jaime Carrasco Colom, Antonio Conejo Fernández, Marta García Ramírez, Rafael Díez Delgado, Carmen Vázquez Ordónez, Enrique Otheo de Tejada, José Couceiro Gianzo, Leonor Arranz, Carmen García-Pardos, Roi Piñeiro-Pérez, Beatriz Bravo Mancheño, Inmaculada López-Molina, Adriana Vidal Acevedo, María Penín Antón, M. Teresa Coll, Berta Pujol Soler, Pilar Ranchal Pérez, Sara Pons Morales, Belén Sevilla, María Méndez Hernández, M. Jesús García-Mazarío, César Gavilán Martín, Elisa Fernández-Cooke, Anna Canet, Marta Ruiz Jiménez, Marina González, Lourdes García Rodríguez, Carmen Moreno, Miren Oscoz Lizarbe, Laura Martín-Pedraz, Miguel Lillo Lillo, Antonio J. Cepillo, Pere Soler-Palacín, Jan Ramakers, Olga Calavia Gasaball, Rebeca Lahoz Ramo, Pedro Terol Barrero, M. José Muñoz Vilchez, Victoria Fumadó Pérez, Silvia Urraca Camps, Elena Urbaneja Rodríguez, M. José Cilleruelo Ortega, Agustín López López, Valentín Pineda Solas, Carla Monterde Pedrab, Rosa Roldán Molina, Sandra Masegosa-Casanova, Paula Alcañiz Rodríguez, Ana Menasalvas Ruíz, Javier Arístegui-Fernández, Elisa Garrote, Federico Martinón-Torres, Irene Rivero-Calle, José Tomás Ramos, Marta Illán Ramos, Beatriz Jiménez Montero, Begoña Losada Pinedo, Borja Guarch Ibáñez, Marcelina Algar Serrano, M. Dolores García, Elena Pereira, Silvia Rodríguez-Blanco, Manuel Muñiz Fontán, Sagrario Bustabab Reyes, Antonio Medina Claros, Isabel Vives Oñós, M. Concepción Mir Perelló, Natalia Cerdeira Barreiro, María Ríos Barnés, Isabel Vara Patudo, Soledad Martínez-Regueira, Raquel Marín Domenech, Juan Salvador Vílchez, Jesús de la Cruz Moreno, Carmelo Guerrero Laleona, Matilde Bustillo Alonso, Leticia Merino Meléndez, and Azucena García Martín

Subjects
Infecciones osteoarticulares, Osteomielitis, Artritis séptica, Diagnóstico, Tratamiento, Pediatrics, RJ1-570
Abstract

Introduction: In 2014 the Consensus Document produced by the Spanish Paediatric Societies (SEIP-SERPE-SEOP) was published to help in the diagnosis and treatment of osteoarticular infections (OAI). In 2015 the RIOPed was considered as a multidisciplinary national network for the investigation into OAI. The aim of this study was to assess the level of adaption to the recommendations established in the Consensus during one year of follow-up. Material and methods: A prospective, national multicentre study was carried out in 37 hospitals between September 2015 and September 2016. The study included patients >16 years-old with a diagnosis of OAI, confirmed by microbiological isolation, or probable: septic arthritis (SA) with >40,000 white cells in synovial fluid, or osteomyelitis (OM)/spondylodiscitis (SD) with a compatible imaging test. The results were compared with those obtained in a retrospective study conducted between 2008 and 2012. Results: A total of 235 cases were included, of which 131 were OM, 79 SA, 30 OA, and 15 SD. As regards the complementary tests that the Consensus considered mandatory to perform, radiography was carried out on 87.8% of the cases, a blood culture on 91.6%, and culture of the synovial fluid in 99% of SA. A magnetic resonance (MR) was performed on 71% of the OM cases. The choice of intravenous empirical antibiotic treatment was adapted to the recommendations in 65.1% of cases, and in 62.3% for the oral treatment. Surgery was performed in 36.8% of SA cases (85.7% arthrotomy), with a significant decrease compared to the retrospective study (P = .014). Only 58.5% of cases followed the recommendations on the duration of the treatment; however, a lower duration of intravenous treatment was observed. Conclusions: In general, the level of adaptation to the recommendations that were set by the Expert Group, is good for the complementary tests, and acceptable as regards the choice of antibiotic treatment, although inadequate in almost 40% of cases. A decrease in hospital stay was achieved. Resumen: Introducción: En 2014 se publicó el Documento de Consenso desarrollado por SEIP-SERPE-SEOP para el diagnóstico y el tratamiento de las infecciones osteoarticulares (IOA). En 2015 se constituyó RIOPed como red nacional multidisciplinar para la investigación en IOA. El objetivo del estudio ha sido valorar el grado de adecuación a las recomendaciones establecidas en el consenso durante un año de seguimiento. Material y métodos: Estudio prospectivo multicéntrico nacional realizado entre septiembre de 2015 y septiembre de 2016 en 37 hospitales con inclusión de pacientes menores de 16 años diagnosticados de IOA, confirmada mediante aislamiento microbiológico, o probable: artritis séptica (AS) con >40.000 leucocitos en líquido sinovial u osteomielitis (OM)/osteoartritis (OA)/espondilodiscitis (ED) con prueba de imagen compatible. Los resultados se compararon con los obtenidos en el estudio retrospectivo realizado entre 2008 y 2012. Resultados: Se incluyeron 255 casos: 131 OM, 79 AS, 30 OA y 15 ED. Respecto a las pruebas complementarias que el consenso consideró de obligada realización, la radiografía se llevó a cabo en el 87,8% de los casos, el hemocultivo en el 91,6% y el cultivo de líquido sinovial en el 99% de AS. Se realizó RM en el 71% de las OM. La elección del tratamiento antibiótico intravenoso empírico se adecuó a las recomendaciones en el 65,1% de los casos, y en el 62,3% para el tratamiento oral. Se llevó a cabo cirugía en el 36,8% de las AS (85,7% artrotomía), con un descenso significativo respecto al estudio retrospectivo (P = ,014). Solo el 58,5% de casos se ajustaron a las recomendaciones de duración del tratamiento; sin embargo, se comprobó una menor duración del tratamiento intravenoso. Conclusiones: En general, el grado de adecuación a las recomendaciones que marcaron el grupo de expertos es bueno para las pruebas complementarias y aceptable respecto a la elección del tratamiento antibiótico, aun detectándose casi un 40% de inadecuación. Se ha conseguido un descenso de la estancia hospitalaria.

Published
2020
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3. Seroprevalence and vertical transmission of Chagas disease in a cohort of Latin-American pregnant women in a tertiary hospital in Madrid

Author

Laura Francisco-González, Teresa Gastañaga-Holguera, Beatriz Jiménez Montero, Zarife Daoud Pérez, Marta Illán Ramos, Paloma Merino Amador, Miguel Ángel Herráiz Martínez, and José Tomás Ramos Amador

Subjects
Enfermedad de Chagas, Transmisión vertical, Cribado prenatal, Pediatrics, RJ1-570
Abstract

Background: Chagas disease, caused by Trypanosoma cruzi (T. cruzi), is endemic in Latin-America and is emerging in Spain due to immigration. The vertical transmission rate is around 5%. A routine prenatal screening with serology of all pregnant women from endemic areas is recommended to identify infected newborns, allowing early treatment and cure. Objective: The aim of this study was to estimate the prevalence of positive Chagas serology in a cohort of pregnant women from Latin-America and its vertical transmission. Patients and methods: An observational, prospective, follow-up study was conducted on women with positive serology to T. cruzi, as well as their newborns, from January 2013 to April 2015. Congenital Chagas was ruled out using a PCR technique at birth and at 1 month, and with serology at 9–12 months old. A child was considered infected when PCR was positive, and uninfected when PCR was negative, and/or it had a negative serology. Results: Screening was performed on 1.244 pregnant women from Latin-America, and there were positive results in 40 (prevalence 3.2%, 95% CI: 2.4–4.4%), with 85% of them from Bolivia.There was only one infected newborn (rate of vertical transmission 2.8% (95% CI: 0–15%)), who had a positive PCR at birth. Relative studies enabled an 8-year-old sister with an asymptomatic disease to be diagnosed and treated. Both were treated successfully with benznidazole (later the PCR and serology were negative). Conclusion: Screening during pregnancy in Latin-American women helped to detect those with Chagas disease. The rate of vertical transmission was 2.8%, in keeping with literature. Screening led to the detection and treatment of previously unidentified familial cases. Resumen: Introducción: La enfermedad de Chagas, causada por Trypanosoma cruzi (T. cruzi), es endémica en Latinoamérica y emergente en España, ligada a inmigración. La transmisión vertical se estima de alrededor del 5%. Se recomienda cribado selectivo en el embarazo para identificar al recién nacido infectado, permitiendo tratamiento precoz y curación de la enfermedad. Objetivo: El objetivo de este estudio fue estimar la prevalencia de serología positiva para T. cruzi en una cohorte de gestantes latinoamericanas y la tasa de transmisión vertical de la misma. Pacientes y métodos: Estudio observacional prospectivo de gestantes con serología positiva para T. cruzi en hospital terciario, desde enero del 2013 hasta abril del 2015. El seguimiento de recién nacidos se realizó con PCR al nacimiento, repetida al mes, y serología a los 9-12 meses. Se consideró infectado al niño con PCR positiva y no infectado al niño con PCR negativa y/o negativización de anticuerpos. Resultados: Se realizó cribado en 1.244 gestantes latinoamericanas, siendo positivas 40 (prevalencia 3,2%, IC del 95%: 2,4-4,4%), 85% procedentes de Bolivia. Solo un niño resultó infectado (transmisión vertical 2,8%, IC del 95%: 0-15%) con PCR positiva al nacimiento. La detección de la embarazada permitió estudiar a los hermanos, detectándose caso asintomático en paciente de 8 años. Ambos tratados con benznidazol con buena tolerancia, evolución favourable y negativización de PCR y anticuerpos. Conclusión: El cribado de embarazadas latinoamericanas ha permitido la detección de gestantes con enfermedad de Chagas. La transmisión vertical fue del 2,3%, coincidente con la literatura. El cribado ha permitido la detección y el tratamiento de casos familiares no identificados previamente.

Published
2018
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4. Seroprevalencia y transmisión vertical de enfermedad de Chagas en una cohorte de gestantes latinoamericanas en un hospital terciario de Madrid

Author

Laura Francisco-González, Teresa Gastañaga-Holguera, Beatriz Jiménez Montero, Zarife Daoud Pérez, Marta Illán Ramos, Paloma Merino Amador, Miguel Ángel Herráiz Martínez, and José Tomás Ramos Amador

Subjects
Chagas disease, Vertical transmission, Prenatal screening, Pediatrics, RJ1-570
Abstract

Resumen: Introducción: La enfermedad de Chagas, causada por Trypanosoma cruzi (T. cruzi), es endémica en Latinoamérica y emergente en España, ligada a inmigración. La transmisión vertical se estima de alrededor del 5%. Se recomienda cribado selectivo en el embarazo para identificar al recién nacido infectado, permitiendo tratamiento precoz y curación de la enfermedad. Objetivo: El objetivo de este estudio fue estimar la prevalencia de serología positiva para T. cruzi en una cohorte de gestantes latinoamericanas y la tasa de transmisión vertical de la misma. Pacientes y métodos: Estudio observacional prospectivo de gestantes con serología positiva para T. cruzi en hospital terciario, desde enero del 2013 hasta abril del 2015. El seguimiento de recién nacidos se realizó con PCR al nacimiento, repetida al mes, y serología a los 9-12 meses. Se consideró infectado al niño con PCR positiva y no infectado al niño con PCR negativa y/o negativización de anticuerpos. Resultados: Se realizó cribado en 1.244 gestantes latinoamericanas, siendo positivas 40 (prevalencia 3,2%, IC del 95%: 2,4-4,4%), 85% procedentes de Bolivia. Solo un niño resultó infectado (transmisión vertical 2,8%, IC del 95%: 0-15%) con PCR positiva al nacimiento. La detección de la embarazada permitió estudiar a los hermanos, detectándose caso asintomático en paciente de 8 años. Ambos tratados con benznidazol con buena tolerancia, evolución favorable y negativización de PCR y anticuerpos. Conclusión: El cribado de embarazadas latinoamericanas ha permitido la detección de gestantes con enfermedad de Chagas. La transmisión vertical fue del 2,3%, coincidente con la literatura. El cribado ha permitido la detección y el tratamiento de casos familiares no identificados previamente. Abstract: Background: Chagas disease, caused by Trypanosoma cruzi (T. cruzi), is endemic in Latin-America and is emerging in Spain due to immigration. The vertical transmission rate is around 5%. A routine prenatal screening with serology of all pregnant women from endemic areas is recommended to identify infected newborns, allowing early treatment and cure. Objective: The aim of this study was to estimate the prevalence of positive Chagas serology in a cohort of pregnant women from Latin-America and its vertical transmission. Patients and methods: An observational, prospective, follow-up study was conducted on women with positive serology to T. cruzi, as well as their newborns, from January 2013 to April 2015. Congenital Chagas was ruled out using a PCR technique at birth and at 1 month, and with serology at 9-12 months old. A child was considered infected when PCR was positive, and uninfected when PCR was negative, and/or it had a negative serology. Results: Screening was performed on 1244 pregnant women from Latin-America, and there were positive results in 40 (prevalence 3.2%, 95% CI: 2.4-4.4%), with 85% of them from Bolivia.There was only one infected newborn (rate of vertical transmission 2.8% (95% CI: 0-15%)), who had a positive PCR at birth. Relative studies enabled an 8-year-old sister with an asymptomatic disease to be diagnosed and treated. Both were treated successfully with benznidazole (later the PCR and serology were negative). Conclusion: Screening during pregnancy in Latin-American women helped to detect those with Chagas disease. The rate of vertical transmission was 2.8%, in keeping with literature. Screening led to the detection and treatment of previously unidentified familial cases.

Published
2018
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5. Epidemiology and clinical features of Streptococcus pyogenes bloodstream infections in children in Madrid, Spain

Author

Elvira Cobo-Vázquez, David Aguilera-Alonso, Tania Carbayo, Lucía M Figueroa-Ospina, Francisco Sanz-Santaeufemia, Fernando Baquero-Artigao, Carmen Vázquez-Ordoñez, Jaime Carrasco-Colom, Daniel Blázquez-Gamero, Beatriz Jiménez-Montero, Carlos Grasa-Lozano, María José Cilleruelo, Ana Álvarez, Cristina Comín-Cabrera, María Penin, Emilia Cercenado, Rut Del Valle, Miguel Ángel Roa, Irene García-De Diego, Cristina Calvo, and Jesús Saavedra-Lozano

Subjects
Pediatrics, Perinatology and Child Health
Published
2023
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6. Epidemiology and Clinical Features of Streptococcus Pyogenes Bloodstream Infections in Children in Spain

Author

Elvira Cobo-Vázquez, David Aguilera-Alonso, Tania Carbayo, Lucía Figueroa-Ospina, Francisco José Sanz-Santaeufemia, Fernando Baquero-Artigao, Carmen Vázquez-Ordoñez, Jaime Carrasco-Colom, Daniel Blázquez-Gamero, Beatriz Jiménez-Montero, Carlos Grasa-Lozano, Maria José Cilleruelo, Ana Álvarez, Cristina Comín-Cabrera, María Penín, Emilia Cercenado-Mansilla, Rut Del Valle, Miguel Ángel Roa, Irene García-De Diego, Cristina Calvo, and Jesús Saavedra-Lozano

Abstract

Purpose: 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 Spanish children over 13 years (2005-2017). Methods: Multicenter retrospective cohort study from 16 Spanish hospitals. Epidemiology, symptomatology, laboratory, treatment, and outcome of GAS-BSI in children ≤16 years were analyzed. Results: 109 cases of GAS-SBI 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 (APC:+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 (7vs.13 days; p=0.003) and received intravenous antibiotics less frequently (72.5%vs.94.8%; p=0.001) and for shorter periods (10vs.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 a trend in increased incidence of GAS-BSI within the study period. 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.

Published
2023
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7. Evaluation of the impact of the Spanish Consensus Document on the approach to osteoarticular infections in Spain through the Paediatrics Osteoarticular Infections Network (RIOPED)

Author

Olga Calavia Gasaball, Matilde Bustillo Alonso, Ana Menasalvas Ruíz, Carmen Moreno, Sandra Masegosa-Casanova, Elisa Garrote, Begoña Losada Pinedo, Elena Pereira, Luis Mayol Canals, Leticia Merino Meléndez, Elena Urbaneja Rodríguez, Antonio José Conejo Fernández, Sara Pons Morales, Antonio J. Cepillo, M. Teresa Coll, Sagrario Bustabab Reyes, Isabel Vives Oñós, Marisol Camacho Lovillo, Rafael Díez Delgado, F. José Sanz Santaeufemia, Neus Rius Gordillo, Manuel Muñiz Fontán, M. José Cilleruelo Ortega, Beatriz Bravo Mancheño, Jan Ramakers, Marcelina Algar Serrano, Cristina Calvo, María Ríos Barnés, Federico Martinón-Torres, Lola Falcón Neyra, Roi Piñeiro-Pérez, Leticia Martínez Campos, Marta García Ramírez, M. Mercedes Bueno Campaña, César G. Fontecha, Lourdes García Rodríguez, Verónica Cardona, Beatriz Jiménez Montero, Rebeca Lahoz Ramo, Daniel Domenech Zarketa, Carmelo Guerrero Laleona, Jaime Carrasco Colom, Pere Soler-Palacín, Patricia Tejera Carreño, Carlos Pérez Méndez, Azucena García Martín, Rosa Roldán Molina, José Couceiro Gianzo, Natalia Cerdeira Barreiro, Carmen García-Pardos, Leonor Arranz, Agustín López López, María Méndez Hernández, Miguel Lillo Lillo, Alfredo Tagarro García, M. Jesús García-Mazarío, Rosa María Alcobendas Rueda, Elena Colino Gil, Pedro Terol Barrero, Adriana Vidal Acevedo, Berta Pujol Soler, Raquel Marín Domenech, M. José Lirola Cruz, Laura Martín-Pedraz, Daniel Clemente Garulo, Elisa Fernández-Cooke, Victoria Fumadó Pérez, Pilar Ranchal Pérez, Javier Arístegui-Fernández, Marta Illán Ramos, Belén Sevilla, Miren Oscoz Lizarbe, Jesús Saavedra-Lozano, Soledad Martínez-Regueira, Antonio Medina Claros, José Tomás Ramos, Marina González, César Gavilán Martín, Anna Canet, Carmen Vázquez Ordónez, Paula Alcañiz Rodríguez, Enrique Otheo de Tejada, M. Dolores García, M. José Muñoz Vilchez, Silvia Rodríguez-Blanco, Irene Rivero-Calle, Marta Ruiz Jiménez, Carla Monterde Pedrab, Silvia Urraca Camps, M. Concepción Mir Perelló, Valentín Pineda Solas, María Penín Antón, Inmaculada López-Molina, Esmeralda Nuñez Cuadros, Juan Salvador Vílchez, Isabel Vara Patudo, Borja Guarch Ibáñez, Susana Melendo-Pérez, and Jesús de la Cruz Moreno

Subjects
Spondylodiscitis, Infecciones osteoarticulares, Pediatrics, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Radiography, Osteomielitis, Antibiotics, RJ1-570, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Management of Technology and Innovation, medicine, Tratamiento, Blood culture, Arthrotomy, medicine.diagnostic_test, business.industry, Osteomyelitis, Diagnóstico, Retrospective cohort study, medicine.disease, Artritis séptica, Septic arthritis, business
Abstract

Introduction: In 2014 the Consensus Document produced by the Spanish Paediatric Societies (SEIP-SERPE-SEOP) was published to help in the diagnosis and treatment of osteoarticular infections (OAI). In 2015 the RIOPed was considered as a multidisciplinary national network for the investigation into OAI. The aim of this study was to assess the level of adaption to the recommendations established in the Consensus during one year of follow-up. Material and methods: A prospective, national multicentre study was carried out in 37 hospitals between September 2015 and September 2016. The study included patients >16 years-old with a diagnosis of OAI, confirmed by microbiological isolation, or probable: septic arthritis (SA) with >40,000 white cells in synovial fluid, or osteomyelitis (OM)/spondylodiscitis (SD) with a compatible imaging test. The results were compared with those obtained in a retrospective study conducted between 2008 and 2012. Results: A total of 235 cases were included, of which 131 were OM, 79 SA, 30 OA, and 15 SD. As regards the complementary tests that the Consensus considered mandatory to perform, radiography was carried out on 87.8% of the cases, a blood culture on 91.6%, and culture of the synovial fluid in 99% of SA. A magnetic resonance (MR) was performed on 71% of the OM cases. The choice of intravenous empirical antibiotic treatment was adapted to the recommendations in 65.1% of cases, and in 62.3% for the oral treatment. Surgery was performed in 36.8% of SA cases (85.7% arthrotomy), with a significant decrease compared to the retrospective study (P = .014). Only 58.5% of cases followed the recommendations on the duration of the treatment; however, a lower duration of intravenous treatment was observed. Conclusions: In general, the level of adaptation to the recommendations that were set by the Expert Group, is good for the complementary tests, and acceptable as regards the choice of antibiotic treatment, although inadequate in almost 40% of cases. A decrease in hospital stay was achieved. Resumen: Introducción: En 2014 se publicó el Documento de Consenso desarrollado por SEIP-SERPE-SEOP para el diagnóstico y el tratamiento de las infecciones osteoarticulares (IOA). En 2015 se constituyó RIOPed como red nacional multidisciplinar para la investigación en IOA. El objetivo del estudio ha sido valorar el grado de adecuación a las recomendaciones establecidas en el consenso durante un año de seguimiento. Material y métodos: Estudio prospectivo multicéntrico nacional realizado entre septiembre de 2015 y septiembre de 2016 en 37 hospitales con inclusión de pacientes menores de 16 años diagnosticados de IOA, confirmada mediante aislamiento microbiológico, o probable: artritis séptica (AS) con >40.000 leucocitos en líquido sinovial u osteomielitis (OM)/osteoartritis (OA)/espondilodiscitis (ED) con prueba de imagen compatible. Los resultados se compararon con los obtenidos en el estudio retrospectivo realizado entre 2008 y 2012. Resultados: Se incluyeron 255 casos: 131 OM, 79 AS, 30 OA y 15 ED. Respecto a las pruebas complementarias que el consenso consideró de obligada realización, la radiografía se llevó a cabo en el 87,8% de los casos, el hemocultivo en el 91,6% y el cultivo de líquido sinovial en el 99% de AS. Se realizó RM en el 71% de las OM. La elección del tratamiento antibiótico intravenoso empírico se adecuó a las recomendaciones en el 65,1% de los casos, y en el 62,3% para el tratamiento oral. Se llevó a cabo cirugía en el 36,8% de las AS (85,7% artrotomía), con un descenso significativo respecto al estudio retrospectivo (P = ,014). Solo el 58,5% de casos se ajustaron a las recomendaciones de duración del tratamiento; sin embargo, se comprobó una menor duración del tratamiento intravenoso. Conclusiones: En general, el grado de adecuación a las recomendaciones que marcaron el grupo de expertos es bueno para las pruebas complementarias y aceptable respecto a la elección del tratamiento antibiótico, aun detectándose casi un 40% de inadecuación. Se ha conseguido un descenso de la estancia hospitalaria.

Published
2020

8. Ventricular Repolarization Parameters and Coronary Involvement in Kawasaki Disease

Author

Ana Barrios-Tascón, Masaru Miura, Sara Domínguez-Rodríguez, Elisa Fernández-Cooke, Georgia Sarquella-Brugada, Alfredo Tagarro, Elisa Fernandez-Cooke, Cristina Calvo, Judith Sánchez-Manubens, Jordi Antón, Javier Aracil Santos, Esmeralda Nuñez Cuadros, Maria Luisa Navarro Gómez, David Moreno Pérez, María Martín Cantero Pérez, Esmeralda Nuñez Cuadros Pérez, Begoña Carazo Gallego Pérez, Fernando Sánchez García, Marisol Camacho Lovillo, Renata Marqués, Olaf Neth Laura, Fernández Silveira, Miguel Sánchez Forte, Ángeles Ortega Montes, Leticia Isabel Martínez Campos, Beatriz Bravo Mancheño, Margarita Camacho, Antonio F. Medina Claros, Carlos Salido, María Torres Rico, Beatriz Ruiz Saez, Elena Fernadez de la Puebla Lechuga, Ma José Lirola Cruz, Kety Maya Carrasco, Moisés Rodríguez González, Enrique Blanca Jover, José Uberos Fernández, María Mercedes Ibáñez Alcalde, Miguel Lafuente Hidalgo, Lorenzo Jiménez Montañés, Matilde Bustillo Alonso, Ariadna Ayerza Casas, Bárbara Montes Zapico, Carlos Pérez Méndez, Javier Fernández Aracama, Lucía Rodríguez, María Aleida Ibáñez Fernández, Sandra Navarro Campo, Silvia Escribà Bori, María Concepción Mir Perelló, Ma Ángeles de la Fuente Sánchez, Patricia Aparicio García, Carlos Briales, Joaquín Castilla Crespí, María Elena Colino Gil, Nerea Delgado Cabrera, Ana Bello Naranjo, Jesús Poch Páez, Moneyba García Yáñez, Montse González García, Maite Viadero, Beatriz Jiménez Montero, Olga Domínguez García, Begoña Losada Pinedo, Gema Iñigo Martín, Lucía María Escribano Gómez, Antonio Cepillo, Miguel Lillo Lillo, María Isabel Buedo, Laura del Rey, Elena Urbaneja Rodríguez, Sara Rellán Rodríguez, Teresa Cantero, Beatriz Plata Izquierdo, Luisa García-Cuenllas Álvarez, Ignacio Oulego Erroz, Elena Pérez Santaolalla, Carlos Alcalde Martín, Fernando Centeno Malfaz, Elena Pérez Gutiérrez, Ma Soledad Jiménez Casso, Fredy Prada, Rosa Bou, Estibaliz Iglesias, Joan Calzada, Olga Calavia Garsaball, Marc Tobeña Rue, Gemma Giralt García, Zulema Lobato, Neus Rius Gordillo, Montserrat Pascual Torres, María Méndez Hernández, Lourdes García, Sergio Flores Villar, Silvia Yevenes Ruiz, Laura Minguell Domingo, Anna Ballester, Ana Miralles, Berta Pujol Soler, Anton Foguet Vidal, Pere Sala Castellví, Angelita Serrano Aguiar, José Manuel Siurana Rodríguez, Anna Sangorrin Iranzo, Roser Álvarez Pérez, Paula Ribes Cajas, Pere Genaró i Jornet, Ana Grande Tejada, Cristina Zarallo, Federico Martinón-Torres, Irene Rivero Calle, Antonio Justicia Grande, María López Sousa, Alejandro Souto Vilas, Bernardo López Abel, Elisa de Miguel Esteban, Bibiana Riaño Méndez, Daniel Blázquez, Pablo Rojo Conejo, Carlos Grasa Lozano, Belén Toral, Leticia Albert De la Torre, Jaime de Inocencio, Mar Santos, Rafael Díaz-Delgado de la Peña, Paz Collado Ramos, Teresa Raga, Libertad Latorre, Sara Guillén, Ignacio Callejas Caballero, Luis Manuel Prieto Tato, María Fernanda Guzmán Monagas, Isabel Jiménez López, Sandra Villagrá, Viviana Arreo, Roi Piñeiro Pérez, María de la Parte, Amalia Tamariz-Martes, Marta Llorente Romano, Maria Belén Hernández Rupérez, Henar Rojo Sombrero, Estefanía García Cerro, Irene Maté Cano, Marta Villares Alonso, Marta Pilar Osuna Marco, Julia Jensen Veron, Cristina Zarallo Reales, María Dolores Rodríguez Mesa, Santiago Rueda Esteban, José Tomás Ramos Amador, Cristina González Menchén, Ana Belén Jiménez Jiménez, Pilar Galán, Dolores Pérez Campos, Ma Mercedes Bueno, David Crespo Marcos, Enrique Otheo de Tejada Barásoain, Walter Alberto Sifuentes Giraldo, María Luz Gámir Gámir, María José Cilleruelo Ortega, Agustín López López, Cristina Sánchez Vaquerizo, Ana Isabel Usano Carrasco, Ester Moreno Gómez, Olga Carvajal del Castillo, Beatriz Del Pozo Menéndez, Katie Badillo Navarro, Fernando Baquero, Lucía Deiros Bronte, Pablo Fernández Fraga, Nieves Domínguez, Beatriz Mercader Rodríguez, Francisco Castro García, Águeda Herrera Chamorro, Paula Alcañiz Rodríguez, Moisés Sorlí García, María Concepción Rex Nicolás, Elena Vera Romero, Patricia Martínez Olorón, Beatriz Rocandio Cilveti, Amaia Berridi, Laura Santos-Díez Vázquez, Olaia Fernández, Inmaculada Calvo, Belén Fernández Tudela, Manuel Oltra Benavent, Marta Dapena Archilés, Franciasco Sanchez Ferrer, César Gavilán, Ignacio Izquierdo Fos, María Isabel Serrano Robles, Yolanda Herranz Sánchez, Enrique Villalobos Pinto, Daniel Clemente Garulo, Stella Pie, Manuel Marrero Calvo, and José María Olmos García

Subjects
Male, medicine.medical_specialty, Ventricular Repolarization, Heart Diseases, Heart Ventricles, Enfermedad cardiovascular, Coronary disease, Mucocutaneous Lymph Node Syndrome, QT interval, 03 medical and health sciences, Recovery period, Electrocardiography, 0302 clinical medicine, Heart Conduction System, 030225 pediatrics, Internal medicine, medicine, Humans, In patient, 030212 general & internal medicine, Enfermedad coronaria, business.industry, Pediatría, Infant, Reproducibility of Results, medicine.disease, Increased risk, Cross-Sectional Studies, Síndrome mucocutáneo linfonodular, Child, Preschool, Pediatrics, Perinatology and Child Health, Cardiology, Kawasaki disease, Female, business
Abstract

Objectives: To evaluate electrocardiogram markers to predict coronary involvement in patients with Kawasaki disease by assessing measures of ventricular repolarization parameters on the 12-lead electrocardiogram. Study design: This cross-sectional study included 180 Spanish and Japanese patients ≤14 years of age with Kawasaki disease, with or without coronary involvement, from 2011 to 2016. We manually measured the Tp-Te/QT ratio and QTc interval (with Bazett's formula) in 12-lead electrocardiogram in the acute and recovery period and explored their potential association with coronary involvement. Results: No association was found between Tp-Te/QT ratio obtained manually in V5 and V6 leads and coronary involvement in the acute (V5:0.25 [IQR, 0.21-0.27] vs 0.25 [IQR, 0.20-0.27], P = .80; V6:0.24 [IQR, 0.21-0.27] vs 0.25 [IQR, 0.20-0.27], P = .86) or the recovery (V5: 0.23 [IQR, 0.20-0.25] vs 0.23 [IQR, 0.19-0.25], P = .68; V6: 0.23 [IQR, 0.20-0.25] vs 0.23 [IQR, 0.17-0.25], P = .50) period. By contrast, QTc in V5 and V6 was significantly lower in patients with Kawasaki disease and coronary involvement in the acute period (V5: 378 ms [IQR, 364-395 ms] vs 390 ms [IQR, 371-411 ms], P = .04; V6: 377 ms [IQR, 364-392 ms] vs 390 ms [IQR, 371-410 ms], P = .01). A QTc interval of

Published
2021

9. Seroprevalencia y transmisión vertical de enfermedad de Chagas en una cohorte de gestantes latinoamericanas en un hospital terciario de Madrid

Author

Beatriz Jiménez Montero, Miguel Ángel Herráiz Martínez, Marta Illán Ramos, José Tomás Ramos Amador, Teresa Gastañaga-Holguera, Laura Francisco-González, Paloma Merino Amador, and Zarife Daoud Pérez

Subjects
Chagas disease, Gynecology, medicine.medical_specialty, business.industry, 030231 tropical medicine, Prenatal screening, medicine.disease, Pediatrics, RJ1-570, 03 medical and health sciences, 0302 clinical medicine, Pediatrics, Perinatology and Child Health, medicine, Seroprevalence, Vertical transmission, 030212 general & internal medicine, business
Abstract

Resumen: Introducción: La enfermedad de Chagas, causada por Trypanosoma cruzi (T. cruzi), es endémica en Latinoamérica y emergente en España, ligada a inmigración. La transmisión vertical se estima de alrededor del 5%. Se recomienda cribado selectivo en el embarazo para identificar al recién nacido infectado, permitiendo tratamiento precoz y curación de la enfermedad. Objetivo: El objetivo de este estudio fue estimar la prevalencia de serología positiva para T. cruzi en una cohorte de gestantes latinoamericanas y la tasa de transmisión vertical de la misma. Pacientes y métodos: Estudio observacional prospectivo de gestantes con serología positiva para T. cruzi en hospital terciario, desde enero del 2013 hasta abril del 2015. El seguimiento de recién nacidos se realizó con PCR al nacimiento, repetida al mes, y serología a los 9-12 meses. Se consideró infectado al niño con PCR positiva y no infectado al niño con PCR negativa y/o negativización de anticuerpos. Resultados: Se realizó cribado en 1.244 gestantes latinoamericanas, siendo positivas 40 (prevalencia 3,2%, IC del 95%: 2,4-4,4%), 85% procedentes de Bolivia. Solo un niño resultó infectado (transmisión vertical 2,8%, IC del 95%: 0-15%) con PCR positiva al nacimiento. La detección de la embarazada permitió estudiar a los hermanos, detectándose caso asintomático en paciente de 8 años. Ambos tratados con benznidazol con buena tolerancia, evolución favorable y negativización de PCR y anticuerpos. Conclusión: El cribado de embarazadas latinoamericanas ha permitido la detección de gestantes con enfermedad de Chagas. La transmisión vertical fue del 2,3%, coincidente con la literatura. El cribado ha permitido la detección y el tratamiento de casos familiares no identificados previamente. Abstract: Background: Chagas disease, caused by Trypanosoma cruzi (T. cruzi), is endemic in Latin-America and is emerging in Spain due to immigration. The vertical transmission rate is around 5%. A routine prenatal screening with serology of all pregnant women from endemic areas is recommended to identify infected newborns, allowing early treatment and cure. Objective: The aim of this study was to estimate the prevalence of positive Chagas serology in a cohort of pregnant women from Latin-America and its vertical transmission. Patients and methods: An observational, prospective, follow-up study was conducted on women with positive serology to T. cruzi, as well as their newborns, from January 2013 to April 2015. Congenital Chagas was ruled out using a PCR technique at birth and at 1 month, and with serology at 9-12 months old. A child was considered infected when PCR was positive, and uninfected when PCR was negative, and/or it had a negative serology. Results: Screening was performed on 1244 pregnant women from Latin-America, and there were positive results in 40 (prevalence 3.2%, 95% CI: 2.4-4.4%), with 85% of them from Bolivia.There was only one infected newborn (rate of vertical transmission 2.8% (95% CI: 0-15%)), who had a positive PCR at birth. Relative studies enabled an 8-year-old sister with an asymptomatic disease to be diagnosed and treated. Both were treated successfully with benznidazole (later the PCR and serology were negative). Conclusion: Screening during pregnancy in Latin-American women helped to detect those with Chagas disease. The rate of vertical transmission was 2.8%, in keeping with literature. Screening led to the detection and treatment of previously unidentified familial cases.

Published
2018

12. Comparison of Mycobacterium lentiflavum and Mycobacterium avium-intracellulare Complex Lymphadenitis

Author

Goosen López, Fernando Baquero-Artigao, María J. Cilleruelo-Ortega, Jesus Garrido, Jesús Saavedra-Lozano, Beatriz Jiménez-Montero, Begoña Santiago-García, Raquel Gómez-García, Inés Galé-Ansó, José Tomás Ramos-Amador, Natalia Marín, Daniel Blázquez-Gamero, and Alfredo Tagarro-García

Subjects
Male, Microbiology (medical), medicine.medical_specialty, Mycobacterium, Microbiology, Lymphadenitis, Clarithromycin, Internal medicine, Humans, Medicine, Child, Pathogen, Mycobacterium avium-intracellulare Infection, Retrospective Studies, biology, business.industry, Cycloserine, Infant, Retrospective cohort study, Mycobacterium avium Complex, bacterial infections and mycoses, biology.organism_classification, Mycobacterium lentiflavum, Infectious Diseases, Spain, Child, Preschool, Pediatrics, Perinatology and Child Health, Mycobacterium avium-intracellulare Complex, Female, Nontuberculous mycobacteria, business, medicine.drug
Abstract

Background: Mycobacterium lentiflavum is considered a rare pathogen causing nontuberculous mycobacterial (NTM) lymphadenitis. Methods: A multicenter, retrospective study was performed in immunocompetent children

Published
2014
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13. [Seroprevalence and vertical transmission of Chagas disease in a cohort of Latin-american pregnant women in a tertiary hospital in Madrid]

Author

Laura Francisco-González, Teresa Gastañaga-Holguera, Beatriz Jiménez Montero, Zarife Daoud Pérez, Marta Illán Ramos, Paloma Merino Amador, Miguel Ángel Herráiz Martínez, and José Tomás Ramos Amador

Subjects
Transmisión vertical, Enfermedad de Chagas, Trypanosoma cruzi, 030231 tropical medicine, Antibodies, Protozoan, Pediatrics, RJ1-570, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Seroepidemiologic Studies, Management of Technology and Innovation, Prevalence, Humans, Chagas Disease, 030212 general & internal medicine, Prospective Studies, Pregnancy Complications, Infectious, Infant, Newborn, Urban Health, Cribado prenatal, Infectious Disease Transmission, Vertical, Latin America, Spain, Female
Abstract

Background: Chagas disease, caused by Trypanosoma cruzi (T. cruzi), is endemic in Latin-America and is emerging in Spain due to immigration. The vertical transmission rate is around 5%. A routine prenatal screening with serology of all pregnant women from endemic areas is recommended to identify infected newborns, allowing early treatment and cure. Objective: The aim of this study was to estimate the prevalence of positive Chagas serology in a cohort of pregnant women from Latin-America and its vertical transmission. Patients and methods: An observational, prospective, follow-up study was conducted on women with positive serology to T. cruzi, as well as their newborns, from January 2013 to April 2015. Congenital Chagas was ruled out using a PCR technique at birth and at 1 month, and with serology at 9–12 months old. A child was considered infected when PCR was positive, and uninfected when PCR was negative, and/or it had a negative serology. Results: Screening was performed on 1.244 pregnant women from Latin-America, and there were positive results in 40 (prevalence 3.2%, 95% CI: 2.4–4.4%), with 85% of them from Bolivia.There was only one infected newborn (rate of vertical transmission 2.8% (95% CI: 0–15%)), who had a positive PCR at birth. Relative studies enabled an 8-year-old sister with an asymptomatic disease to be diagnosed and treated. Both were treated successfully with benznidazole (later the PCR and serology were negative). Conclusion: Screening during pregnancy in Latin-American women helped to detect those with Chagas disease. The rate of vertical transmission was 2.8%, in keeping with literature. Screening led to the detection and treatment of previously unidentified familial cases. Resumen: Introducción: La enfermedad de Chagas, causada por Trypanosoma cruzi (T. cruzi), es endémica en Latinoamérica y emergente en España, ligada a inmigración. La transmisión vertical se estima de alrededor del 5%. Se recomienda cribado selectivo en el embarazo para identificar al recién nacido infectado, permitiendo tratamiento precoz y curación de la enfermedad. Objetivo: El objetivo de este estudio fue estimar la prevalencia de serología positiva para T. cruzi en una cohorte de gestantes latinoamericanas y la tasa de transmisión vertical de la misma. Pacientes y métodos: Estudio observacional prospectivo de gestantes con serología positiva para T. cruzi en hospital terciario, desde enero del 2013 hasta abril del 2015. El seguimiento de recién nacidos se realizó con PCR al nacimiento, repetida al mes, y serología a los 9-12 meses. Se consideró infectado al niño con PCR positiva y no infectado al niño con PCR negativa y/o negativización de anticuerpos. Resultados: Se realizó cribado en 1.244 gestantes latinoamericanas, siendo positivas 40 (prevalencia 3,2%, IC del 95%: 2,4-4,4%), 85% procedentes de Bolivia. Solo un niño resultó infectado (transmisión vertical 2,8%, IC del 95%: 0-15%) con PCR positiva al nacimiento. La detección de la embarazada permitió estudiar a los hermanos, detectándose caso asintomático en paciente de 8 años. Ambos tratados con benznidazol con buena tolerancia, evolución favourable y negativización de PCR y anticuerpos. Conclusión: El cribado de embarazadas latinoamericanas ha permitido la detección de gestantes con enfermedad de Chagas. La transmisión vertical fue del 2,3%, coincidente con la literatura. El cribado ha permitido la detección y el tratamiento de casos familiares no identificados previamente.

Published
2016

14. Once-daily antiretroviral therapy in a cohort of HIV-infected children and adolescents

Author

M. Isabel de José-Gómez, Miguel A. Roa-Francia, Jorge Martínez-Pérez, M. Luisa Navarro-Gómez, Dolores Gurbindo-Gutierrez, M. Isabel González-Tomé, Jesús Saavedra-Lozano, Beatriz Jiménez-Montero, Santiago Jiménez de Ory, José Beceiro, M. José Mellado-Peña, Pablo Rojo-Conejo, and José Tomás Ramos-Amador

Subjects
Microbiology (medical), Male, Pediatrics, medicine.medical_specialty, Adolescent, business.industry, HIV Infections, Antiretroviral therapy, Medication Adherence, Cohort Studies, Infectious Diseases, Anti-Retroviral Agents, Pill, Hiv infected, Antiretroviral Therapy, Highly Active, Pediatrics, Perinatology and Child Health, Cohort, Medicine, Humans, Female, Once daily, business, Child, Retrospective Studies
Abstract

We evaluated the evolution over time of once-daily antiretroviral therapy in HIV-infected children and its relationship with adherence. An increase on the prevalence of once-daily antiretroviral therapy was observed over time (from 0.9% in 2002 to 44.2% in 2011). There was no difference in adherence regarding once-daily or BID regimens in 2011. Adherence was related to age and pill burden.

Published
2014

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