SARS-CoV-2 infection in newborn infants: descriptive epidemiological analysis of cases reported to the Colombian national surveillance system during the first pandemic year, March 2020-February 2021.

OBJECTIVE: To describe the clinical and epidemiological characteristics of newborn infants with SARS-CoV-2 infection notified in the Colombian Public Health Surveillance System. DESIGN: This epidemiological descriptive analysis was conducted using the data of all cases of newborn infants with confirmed SARS-CoV-2 infection notified in the surveillance system. Absolute frequencies and central tendency measures were calculated and a bivariate analysis comparing variables of interest with symptomatic and asymptomatic disease was performed. SETTING: Population-based descriptive analysis. PATIENTS: Laboratory-confirmed COVID-19 cases in newborn infants (aged ≤28 days of life) reported to the surveillance system from 1 March 2020 to 28 February 2021. RESULTS: 879 newborns were identified, corresponding to 0.04% of all reported cases in the country. The mean age at diagnosis was 13 days (range 0-28 days), 55.1% were male and most (57.6%) were classified as symptomatic. Preterm birth and low birth weight were identified in 24.0% and 24.4% of the cases, respectively. Common symptoms were fever (58.3%), cough (48.3%) and respiratory distress (34.9%). A higher prevalence of symptomatic newborns was seen in individuals with low birth weight for gestational age (prevalence ratio (PR): 1.51, 95% CI: 1.44 to 1.59) and newborns with underlying conditions (PR: 1.33, 95% CI: 1.13 to 1.55). CONCLUSIONS: There were a low proportion of confirmed COVID-19 cases in the newborn population. A substantial number of newborns were classified as symptomatic, having low birth weight and being preterm. Clinicians caring for COVID-19-infected newborns should be aware of population characteristics that potentially contribute to disease manifestations and severity.

Differences Between Methicillin-susceptible Versus Methicillin-resistant Staphylococcus aureus Infections in Pediatrics: Multicenter Cohort Study Conducted in Bogotá, Colombia, 2014-2018.

BACKGROUND: The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) has changed in recent years. The present article is intended to establish differences between clinical, laboratory and imaging findings and outcomes of MSSA and MRSA infections, as well as among subgroups of infection such as skin and soft tissue infection, osteoarticular, bacteremia or pneumonia in a pediatric population from Bogota, Colombia. METHODS: Retrospective cohort study using clinical records of patients under 18 years of age treated at the participating centers in Bogota, Colombia, between 2014 and 2018. The first positive S. aureus culture was studied. MSSA and MRSA were compared. The χ2 test, Fisher exact test, and Kruskal-Wallis test were calculated, and the statistical significance was presented using the difference and its 95% CI. RESULTS: Five hundred fifty-one patients were included; 211 (38%) corresponded to MRSA and 340 (62%) to MSSA for a total of 703 cultures. A significantly higher probability of having an MSSA infection than MRSA was found in patients with previous heart disease (3.3% vs. 0.5%), neurologic disease (5.9% vs. 2.5%), recent major surgeries (11% vs. 5%) or who has an implanted device (11% vs. 4%). In contrast, in severe MRSA infections (bacteremia, osteoarticular infections and pneumonia), a higher rate of complications was seen (admission to the pediatric intensive care unit, mechanical ventilation and vasoactive support), and in osteoarticular MRSA, more than 1 surgery per case was seen (89% vs. 61%). Laboratory results and mortality were similar. CONCLUSIONS: MRSA was associated with a more severe course in bacteremia, osteoarticular infections and pneumonia. Some classical risk factors associated with MRSA infections were found to be related to MSSA. In general, with the exception of skin and soft tissue infection, there was an increased risk of pediatric intensive care unit admission and mechanical and inotropic support with MRSA in a pediatric population.

Tiflitis neutropénica en niños / Neutropenic typhlitis in children

Introducción. La tiflitis es una colitis necrozante con inflamación del ciego en pacientes neutropénicos, usualmente diagnosticada en la autopsia. Material y métodos. identificamos 18 niños hospitalizados en el Hospital Infantil de México Federico Gómez en un período de 10 años, con presencia de fiebre, dolor e hipersensibilidad abdominal sugestiva de tiflitis neutropénica. Resultados. Ocho de los 18 pacientes tenían evidencia radiológica de tiflitis en las radiografías de abdomen. Todos los pacientes presentaron neutropenia al momento del diagnóstico y 9 tenían bacteriemia documentada. Los 18 pacientes fueron tratados con diversos antibióticos, 4 de ellos sometidos a cirugía y 1 a colonoscopia. Once pacientes murieron, 10 se mejoraron médicamente y 1 quirúrgicamente. En orden de frecuencia, la tiflitis fue identificada en 9 pacientes con leucemia aguda no linfoide, en 6 con leucemia aguda linfoide; en 1 con anemia aplásica, neutropenia cíclica y carcinoma renal, respectivamente. Sólo 4 pacientes recibieron factor estimulador de colonias de granulocitos; y en todos los pacientes que sobrevivieron se observó un aumento de leucocitos polimorfonucleares a más de 500/mm3 documentado entre el cuarto y el décimosexto día de manejo médico y/o quirúrgico. Conclusiones. Recomendamos que ante un paciente con fiebre y neutropenia, con dolor e hipersensibilidad abdominal, además de datos como diarrea hematemesis se debe plantear como diagnóstico tiflitis neutropénia e instaurarse el manejo general y específico que incluye la valoración quirúrgica