RESUMEN
Background: Staphylococcus aureus infections are a significant cause of morbidity and mortality in pediatric populations worldwide. The Staphylo Research Network conducted an extensive study on pediatric patients across Colombia from 2018 to 2021. The aim of this study was to describe the epidemiological and microbiological characteristics of S. aureus in this patient group. Methods: We analyzed S. aureus isolates from WHONET-reporting centers. An "event" was a positive culture isolation in a previously negative individual after 2 weeks. We studied center characteristics, age distribution, infection type, and antibiotic susceptibilities, comparing methicillin sensitive (MSSA) and resistant S. aureus (MRSA) isolates. Results: Isolates from 20 centers across 7 Colombian cities were included. Most centers (80%) served both adults and children, with 55% offering oncology services and 85% having a PICU. We registered 8,157 S. aureus culture isolations from 5,384 events (3,345 MSSA and 1,961 MRSA) in 4,821 patients, with a median age of 5 years. Blood (26.2%) and skin/soft tissue (18.6%) were the most common infection sources. Most isolates per event remained susceptible to oxacillin (63.2%), clindamycin (94.3%), and TMP-SMX (98.3%). MRSA prevalence varied by city (<0.001), with slightly higher rates observed in exclusively pediatric hospitals. In contrast, the MRSA rate was somewhat lower in centers with Antimicrobial Stewardship Program (ASP). MRSA was predominantly isolated from osteoarticular infections and multiple foci, while MSSA was more frequently associated with recurrent infections compared to MRSA. Conclusions: This is the largest study of pediatric S. aureus infections in Colombia. We found MSSA predominance, but resistance have important regional variations. S. aureus remains susceptible to other commonly used antibiotics such as TMP-SMX and clindamycin. Ongoing monitoring of S. aureus infections is vital for understanding their behavior in children. Prospective studies within the Staphylored LATAM are underway for a more comprehensive clinical and genetic characterization.
RESUMEN
La leptospirosis es una zoonosis con manifestaciones clínicas causadas por espiroquetas patógenas del género Leptospira spp. Su curso puede ser desde enfermedad leve hasta un síndrome ictero-hemorrágico severo denominado enfermedad de Weil. Se estudió un brote epidemiológico constituido por una serie de cuatro casos de leptospirosis de severidad moderada a severa, ocurridos en una zona rural de clima tropical en los llanos orientales de Colombia, a 450 metros sobre el nivel del mar en una familia visitante en Puerto Lleras, Meta, Colombia. Probablemente secundario al consumo de aguas contaminadas por orina de roedores. Las pacientes fueron ingresadas bajo la sospecha de un síndrome ictérico de origen infeccioso con un falso positivo para antígeno de superficie de hepatitis B. Dos pacientes desarrollaron síndrome de Weil asociado a microangiopatía trombótica por lo que requirieron manejo en unidad de cuidados intensivos (UCI) sin embargo, una de ellas fallece y las otras dos pacientes desarrollan signos y síntomas moderados evidenciando un curso variable de la enfermedad. En nuestro país existe una sobre notificación de síndromes febriles, ictéricos e icterohemorragicos de diferentes etiologías y difícil diagnóstico por lo que la leptospirosis tiende a ser confundida o ignorada como diferencial en muchos casos.
Leptospirosis is a zoonosis with clinical manifestations caused by pathogenic spirochetes of the genus Leptospira spp. Its course can range from mild illness to a severe jaundice-hemorrhagic syndrome called Weil's disease. An epidemiological outbreak consisting of a series of four cases of leptospirosis of moderate to severe severity, which occurred in a rural area with a tropical climate in the eastern plains of Colombia, at 450 meters above sea level, was studied in a visiting family in Puerto Lleras, Meta, Colombia. Probably secondary to the consumption of water contaminated by rodent urine. The patients were admitted on suspicion of an infectious jaundice syndrome with a false positive for hepatitis B surface antigen. Two patients developed Weil's syndrome associated with thrombotic microangiopathy, requiring ICU management, however, one of them died and the other two patients develop moderate signs and symptoms showing a variable course of the disease. In our country there is an overreporting of febrile, jaundice and jaundice syndromes of different etiologies and difficult diagnosis, so that leptospirosis tends to be confused or ignored as differential in many cases.