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INTRODUCTION: Dalbavancin is an antibiotic active against most Gram-positive bacteria approved for acute bacterial skin and skin structure infections (ABSSSI). Owing to its long half-life, it is being increasingly used for other indications. PATIENTS AND METHODS: We present a case series of children and adolescents treated with dalbavancin for osteoarticular, catheter-related and other non-ABSSSI infections. RESULTS: Dalbavancin was prescribed to 15 patients. Six (40%) were female and median age at prescription was 11.9 (IQR 1.3-18.0) years. Most of them (12/15) had significant comorbidities. Patients presented mainly with deep surgical site infections, osteoarticular infections and central-line-associated bloodstream infections. The most common isolate was Staphylococcus aureus followed by Staphylococcus epidermidis. Major reasons to prescribe dalbavancin were to ensure compliance and patients' convenience. Two patients discontinued the drug due to adverse events possibly related to it. The rest of the patients completed the treatment with dalbavancin, with a median duration of 56 days (IQR 17.5, 115.5). All achieved complete resolution and present no relapse after a median follow-up of 9.9 months (IQR 4.8, 16.6). CONCLUSIONS: Dalbavancin was a safe, effective and convenient alternative in selected paediatric patients with complicated non-ABSSSI infections caused by Gram-positive bacteria.
Asunto(s)
Antibacterianos , Uso Fuera de lo Indicado , Teicoplanina , Humanos , Teicoplanina/análogos & derivados , Teicoplanina/uso terapéutico , Teicoplanina/efectos adversos , Teicoplanina/administración & dosificación , Femenino , Niño , Antibacterianos/uso terapéutico , Antibacterianos/efectos adversos , Antibacterianos/administración & dosificación , Masculino , Preescolar , Lactante , Adolescente , Resultado del Tratamiento , Infecciones Relacionadas con Catéteres/tratamiento farmacológico , Infecciones Relacionadas con Catéteres/microbiología , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Infecciones por Bacterias Grampositivas/microbiología , Infección de la Herida Quirúrgica/tratamiento farmacológico , Infección de la Herida Quirúrgica/microbiologíaRESUMEN
OBJECTIVE: The objective of this study was to assess the role of T-lymphocyte immune responses in newborns with congenital cytomegalovirus (CMV) infection (cCMV) and their potential association with the development of long-term sequelae. STUDY DESIGN: A multicenter, prospective study from 2017 to 2022 was conducted across 8 hospitals in Spain. Blood samples were collected within the first month of life from neonates diagnosed with cCMV. Intracellular cytokine staining was employed to evaluate the presence of CMV-specific interferon-gamma (IFN-γ)-producing CD8+ and CD4+ T lymphocytes (CMV-IFN-γ-CD8+/CD4+) using flow cytometry. The development of sequelae, including hearing loss and neurologic impairment, was assessed during follow-up. RESULTS: In total, 64 newborns were included; 42 infants (65.6%) had symptomatic cCMV. The median age at the last follow-up visit was 25.3 months (IQR 20.1-34.4). Eighteen infants had long-term sequelae (28.1%), predominantly hearing loss (20.3%) and neurologic disorders (15.6%). No relationship was observed between total count or percentage of CMV-specific IFN-γ-CD8+ or CD4+ lymphocytes and long-term sequelae. Multivariable analysis demonstrated an association between lower total lymphocyte count and long-term sequelae (aOR 0.549, 95% CI: 0.323-0.833), which requires further study. CONCLUSIONS: CMV-specific IFN-γ-CD4+ and CD8+ T-lymphocyte responses in neonates with cCMV were not predictive of long-term sequelae.
RESUMEN
En este trabajo se hacen algunas consideraciones sobre la memoria y el olvido, se describen complejos procesos emocionales individuales y familiares que dan lugar a determinados estados psicológicos colectivos que suelen configurarse bajo las dictaduras y los estados totalitarios. Reflexiones que se enmarcan en el contexto de la reciente historia de España y que ayudarán a comprender, al menos en parte, el enorme retraso que la recuperación de la memoria ha tenido en nuestro país. Estas aportaciones están apoyadas en fuentes históricas, sociológicas, literarias y basadas en la teoría y la práctica clínica psicológica aplicada a tratamientos individuales, de familia y de grupos. (AU)
In this work, some considerations are made about memory and forgetting, complex individual and family emotional processes that give rise to certain collective psychological states that are usually configured under dictatorships and totalitarian states are described. These reflections are framed in the context of Spains recent history and will help to understand, at least in part, the enormous delay that the recovery of memory has had in our country. These contributions are supported by historical, sociological, and literary sources and based on psychological theory and clinical practice applied to individual, family, and group treatments. (AU)
Asunto(s)
Historia del Siglo XX , Memoria , Psicología , EspañaRESUMEN
En este trabajo se hacen algunas consideraciones sobre la memoria y el olvido, se describen complejos procesos emocionales individuales y familiares que dan lugar a determinados estados psicológicos colectivos que suelen configurarse bajo las dictaduras y los estados totalitarios. Reflexiones que se enmarcan en el contexto de la reciente historia de España y que ayudarán a comprender, al menos en parte, el enorme retraso que la recuperación de la memoria ha tenido en nuestro país. Estas aportaciones están apoyadas en fuentes históricas, sociológicas, literarias y basadas en la teoría y la práctica clínica psicológica aplicada a tratamientos individuales, de familia y de grupos. (AU)
In this work, some considerations are made about memory and forgetting, complex individual and family emotional processes that give rise to certain collective psychological states that are usually configured under dictatorships and totalitarian states are described. These reflections are framed in the context of Spains recent history and will help to understand, at least in part, the enormous delay that the recovery of memory has had in our country. These contributions are supported by historical, sociological, and literary sources and based on psychological theory and clinical practice applied to individual, family, and group treatments. (AU)
Asunto(s)
Historia del Siglo XX , Memoria , Psicología , EspañaRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pandemias , Medicina Basada en la Evidencia , Infecciones por Coronavirus/tratamiento farmacológico , Neumonía Viral/tratamiento farmacológico , Prevalencia , España/epidemiologíaRESUMEN
No disponible