RESUMO
BACKGROUND: Information on the impact of the different variants in children in Latin America is scarce. The objective of this study was to describe epidemiologic and clinical features of COVID-19 infection in children under 18 years of age in Argentina, comparing the periods before and after the circulation of new variants. METHODS: Observational, cross-sectional, multicentric, analytical study. All patients under 18 years of age with confirmed SARS-CoV-2 infection admitted at 22 healthcare centers were included. Two study periods were established: Period 1 (EW10-2020 to EW12-2021) for the Wuhan strain; Period 2 (EW13 to EW35 2021) for Alpha, Gamma, Delta and Lambda variants. FINDINGS: A total of 6330 confirmed cases were included. Period 1: 3575 (56.5%), period 2: 2755 (43.5%). During period 2, a lower number of asymptomatic cases was observed, while general, respiratory and neurologic signs and symptoms increased in all age groups. Oxygen therapy requirement was higher during the first period (36.7% vs 19.1%; P < 0.001). No significant differences were observed in the rates of severe or critical cases (6.3% vs 5,4%; P = 0.102), intensive care admission (2.1% vs 2%; P < 0.656) or case fatality (0.3% vs 0.5 %; P < 0.229). MIS-C cases occurred more frequently during the first period (1.9% vs 1.1%; P = 0.009). INTERPRETATION: The clinical spectrum of COVID-19 in Argentina has evolved. With the emergence of new variants, although the number of asymptomatic cases declined, numbers of severe and critical cases, as well as case fatality rates in children, remained unchanged.
Assuntos
COVID-19 , Infecções por Coronavirus , Pneumonia Viral , Adolescente , Criança , Humanos , Argentina/epidemiologia , Betacoronavirus , Infecções por Coronavirus/diagnóstico , COVID-19/epidemiologia , Estudos Transversais , Pneumonia Viral/diagnóstico , SARS-CoV-2RESUMO
BACKGROUND: Neisseria meningitidis (Nm) pharyngeal carriage is a necessary condition for invasive disease. We present the first carriage study in children in Buenos Aires, Argentina, considering 2017 as a transition year. Aims: to assess the rate of Nm carriage, to determine genogroup, clonal complex and outer membrane protein distribution, to determine carriage risk factors by age. METHODS: Cross-sectional study including children 1-17 yrs, at Ricardo Gutiérrez Children's Hospital in Buenos Aires 2017. Oro-pharyngeal swabs were taken and cultured within a short time after collection. Genogroup was determined by PCR and clonal complex by MLST. Categorical variables were analyzed. RESULTS: A total of 1,751 children were included. Group 1: 943 children 1-9 yrs, 38 Nm were isolated; overall carriage 4.0%. Genogroup distribution: B 26.3%, W 5.3%, Y 2.6%, Z 5.3%, other groups 7.9% and capsule null (cnl) 52.6%. Participating in extracurricular activities was the only independent predictor of Nm carriage. Group 2: 808 children 10-17 yrs, 76 Nm were isolated; overall carriage 9.4%. Genogroup distribution: B 19.7%, C 5.3%, W 7.9%, Y 9.2%, Z 5.3%, other groups 7.9% and cnl 44.7%. Independent predictors of carriage: attending pubs/night clubs and passive smoking (adjusted OR: 0.55, 95%CI = 0.32-0.93; p = 0.025). CONCLUSIONS: Overall carriage was higher in 10-17 yrs. The isolates presenting the cnl locus were prevalent in both age groups and genogroup B was the second most frequent.
Assuntos
Infecções Meningocócicas/diagnóstico , Neisseria meningitidis/isolamento & purificação , Orofaringe/microbiologia , Adolescente , Argentina , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Tipagem de Sequências MultilocusRESUMO
La varicela es una infección viral aguda, con elevada transmisibilidad. Si bien en la mayor parte de los casos cursa como una infección benigna, puede presentar complicaciones en ciertos grupos de riesgo fundamentalmente en el ámbito hospitalario. El siguiente artículo resume los aspectos más importantes del abordaje de los pacientes expuestos a varicela, focalizando en el manejo epidemiológico de los contactos susceptibles en el ámbito de los servicios de salud
Chickenpox is an acute viral infection, with high transmissibility. Although, in most cases, it is a benign infection, it can cause complications in certain risk groups, mainly in the hospital setting. The following article summarizes the most important aspects of the management of patients exposed to varicella, focusing on the epidemiological management of susceptible contacts in the field of health care services
Assuntos
Humanos , gama-Globulinas , Varicela , Grupos de Risco , Herpesvirus Humano 3RESUMO
La infección relacionada con catéter es una de lasprincipales complicaciones en los pacientes concatéteres venosos centrales. El tratamiento convencionalimplica, muchas veces, retirar el dispositivo ytratamiento antibiótico prolongado. La terapiaantibiótica de bloqueo requiere la instilación de altasconcentraciones de antibióticos en la luz del catéter.Presentamos un paciente de nueve años con osteosarcomae infección asociada a catéter con reservorioimplantable por Pantoea agglomerans, tratadoexitosamente con terapia de bloqueo en el Hospitalde Niños Dr. Ricardo Gutiérrez. El objetivo fuecomunicar al pediatra la posibilidad de terapéuticaadicional (terapia de bloqueo) en niños con infecciónrelacionada con catéter.Palabras clave: infección relacionada con catéter, tratamiento,niños.
Assuntos
Criança , Antibacterianos , Infecções/terapia , Cateteres de Demora/efeitos adversos , Pantoea/patogenicidadeRESUMO
La infección relacionada con catéter es una de lasprincipales complicaciones en los pacientes concatéteres venosos centrales. El tratamiento convencionalimplica, muchas veces, retirar el dispositivo ytratamiento antibiótico prolongado. La terapiaantibiótica de bloqueo requiere la instilación de altasconcentraciones de antibióticos en la luz del catéter.Presentamos un paciente de nueve años con osteosarcomae infección asociada a catéter con reservorioimplantable por Pantoea agglomerans, tratadoexitosamente con terapia de bloqueo en el Hospitalde Niños ¶Dr. Ricardo Gutiérrez÷. El objetivo fuecomunicar al pediatra la posibilidad de terapéuticaadicional (terapia de bloqueo) en niños con infecciónrelacionada con catéter.Palabras clave: infección relacionada con catéter, tratamiento,niños.(AU)
