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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.Children17 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.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).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.

Background:Although most cases of SARS-CoV-2 infection in pediatric population are asymptomatic or mild, severe cases may occur in a small percentage. Unlike other respiratory infections, children usually develop it from infected adults. Percentage of seroconversión and outcome of antibodies after infection anti-SAR-CoV-2 in children are still poorly understood and may be different from adults. The first aim was to describe clinical and epidemiological characteristics of pediatric patients diagnosed of SARS-CoV-2 infection in the second epidemic wave in two tertiary hospitals in Madrid, Spain and to determine the proportion of seronegative by comparing 3 serological techniques. As secondary aim it was proposed to determine the proportion of seronegative by comparing 3 serological techniques, seroconversion associated variables and the way of infection among the family members. Methods:Multicenter prospective observational study in two university hospitals of the Community of Madrid, between September and November 2020, of COVID-19 infection confirmed by PCR in the Emergency Department. A retrospective data collection was performed at 4-8 weeks after diagnosis on an outpatient basis, using a clinical-epidemiological questionnaire. At this time blood samples were collected to analyse the humoral response by 3 different serological assays.The quantitative variables are expressed as medians (interquartile range (IQR) 25-75).Univariate analysis of possible factors associated with seropositivity absence was performed.Results: One hundred and eleven patients (58 girls) were included with a median days of 37 (IQR: 34-44) between diagnosis and serologic test performed.Median age was 88 (IQR: 24-149) months. Parents were from abroad in 62 cases (50% from South and Central America).Ninety eight children were symptomatic, 17 children were diagnosed by epidemiological screening, 4 of whom subsequently developed symptoms.Eight of them needing admission with a median length of stay 2 days (IQR: 2-4), none of them in PICU.Underlying conditions were found in 33 patients, mainly recurrent bronchitis.Most frequent symptoms (70%) were low-grade fever (37-38ºC) or fever (≥ 38ºC), rhinorrhea 44%, cough 31.5%, headache 29.7%, weakness 27%, diarrhea 19.8%, abdominal pain and vomiting 26%, anosmia 16.2% (median 10 days; IQR: 6-30). Infection was interpreted as a secondary case in 56 patients, being a relative the index case in 96.4%. Seronegativity was observed in 19 patients in any of the 3 serological techniques (17.1%; 95% CI: 10.6-25.4), this proportion was higher among children aged 2-to 10-year-old age (16 of 45; 35%, p Conclusions: Our results confirm the mild clinical picture in children during the second epidemic wave, and that in most cases, children are not the index case in the family. Likewise, in children the proportion in whom seroconversion is not detected is high, and seems higher than that reported in adults. In our series, an association of seronegativity was seen in the 2 to 10 year-old age group and when there was no documentation of COVID-19 in any household contact.

Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is an important problem of public health even in regions where it is not endemic. Spain ranks second worldwide in terms of imported cases of T. cruzi infection in the chronic phase. The diagnosis in this stage is made via the detection of antibodies against T. cruzi. Therefore, we aimed to evaluate the sensitivity and specificity of two fully automated chemiluminescence immunoassays, Chagas VirClia® (CHR), which uses a mixture of recombinant antigens, and Chagas TESA VirClia® (TESA), the first chemiluminescence assay based on excretion-secretion antigens of trypomastigotes, both designed in monotest format. A retrospective case–control study was performed using 105 well-characterized samples: 49 from patients with CD, 22 from uninfected individuals, and 32 from patients with other pathologies. Sensitivity was 98% for CHR and 92% for TESA. In contrast, the specificity in both was 100%. Cross-reactivity was observed in leishmaniasis (2/10). CHR meets the criteria to become a tool for serological screening, while TESA has the potential for confirmation and cross-reaction discrimination. The monotest format allows its application in laboratories with a small number of samples. The high specificity of both assays is useful in areas where leishmaniasis is endemic.

We conducted a multicenter clinical validity study of the Panbio coronavirus disease 2019 Antigen Rapid Test of nasopharyngeal samples in pediatric patients with coronavirus disease 2019-compatible symptoms of ≤5 days of evolution. Our study showed limited accuracy in nasopharyngeal antigen testing: overall sensitivity was 45.4%, and 99.8% of specificity, positive-predictive value was 92.5%.