Adolescent Tuberculosis: 6 Years of Experience in a Tertiary Care Pediatric Hospital in Buenos Aires, Argentina.

INTRODUCTION: Adolescence is a key risk period for tuberculosis disease and its adverse outcomes. This group commonly develops infectious forms of tuberculosis and has a wider range of social contacts outside the household. There are few specific data on the behavior of tuberculosis disease in this population. METHODS: A total of 292 patients 10-19 years of age with tuberculosis between January 2016 and December 2021 were retrospectively analyzed in the Department of Phthisiology of the Children's Hospital "Dr. Ricardo Gutiérrez" of Buenos Aires, Argentina. RESULTS: The median patient age was 14 years (interquartile range 12-16). Most patients were previously healthy, and 55% were unaware of the source of the infection. However, 75% sought medical advice owing to the presence of symptoms, with hemoptysis and weight loss being most frequent in those older than 15 years. Lung imaging findings consistent with severe disease were significantly associated with an age of >15 years. Respiratory cultures were positive in 62% of the samples obtained. Half of the patients required hospitalization, while 45% showed extrapulmonary involvement. Evolution was as follows: 74% recovered from the illness, 13% were lost to follow-up, 11% were referred to a less complex facility, 1% experienced treatment failure, and 3 (1%) patients died. Pulmonary cavities and positive bacilloscopy were associated with the presence of pulmonary sequelae at the end of treatment. CONCLUSIONS: Tuberculosis in adolescents, particularly in those >15 years of age, may present characteristics similar to those of adults, with a higher frequency of severe pulmonary disease leading to pulmonary sequelae.

[Phaeohyphomycosis by Exserohilum rostratum in a pediatric patient with acute lymphoblastic leukemia after bone marrow transplantation]. / Feohifomicosis por Exserohilum rostratum en un paciente pediátrico con leucemia linfoblástica aguda postransplante de médula ósea.

The genus Exserohilum consists of dematiaceous or darkly pigmented fungi. Most of the species included in this genus are phytopathogens, saprobes and only three of these species would be pathogenic to humans: Exserohilumrostratum, Exserohilumlongirostratum and Exserohilummcginnisii. Localized and systemic infections have been reported both in immunocompetent and immunosuppressed patients. A clinical case of cutaneous infection by E. rostratum in an immunocompromised pediatric patient is presented in this study.'

Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus in Cystic Fibrosis Patients from Argentina.

Methicillin-resistant Staphylococcus aureus (MRSA) colonization in cystic fibrosis (CF) patients is an increasing problem in many countries. In our Respiratory Center at the Hospital de Niños "Dr. Ricardo Gutiérrez", Buenos Aires, Argentina, the prevalence has climbed from 23% in 1995 up to 32% in 2011. Our objective was to analyze the diversity of MRSA isolates recovered from respiratory samples of CF patients attending our center, characterizing their phenotypes and clonal distribution. Therefore, a prospective study was conducted on all CF patients attending the pediatric Respiratory Center between June 2012 and May 2013 to collect MRSA isolates. Antibiotic susceptibility testing, multilocus sequence typing, pulsed-field gel electrophoresis, spa typing, and agr genotyping were performed on collected isolates. The prevalence of MRSA during this period was 34.2%, and 71.9% of the patients were infected with isolates that carried SCCmec IV. High resistance rates were detected for gentamicin, erythromycin, clindamycin, ciprofloxacin, and rifampicin. Strains related to the community-associated MRSA clones, ST5-IV and ST30-IV, were the most frequently recovered. Remarkably, even though most of the isolates were related to these clones, the rate of multi-resistance shown in CF patients was higher than that reported for the same lineages recovered from other infections in our country.