[Hospital admissions for varicella complications in children aged less than 15 years old]. / Hospitalizaciones por complicaciones de la varicela en niños menores de 15 años.

BACKGROUND: The complications of varicella are one of the arguments in favor of universal vaccination programs in children. OBJECTIVE: To describe the complications of varicella requiring hospital admission in a well-defined population (Gipuzkoa, Spain) and to compare the incidence of hospitalization with that reported in other series. MATERIAL AND METHODS: Observational, retrospective, multicenter study of admissions for varicella. The medical histories codified as varicella (minimum data set, CIE-0, codes 952.0-052.9) from 1 January 1993 to 31 December 2002 were reviewed. Calculation of hospitalization rates was based on emergency department visits and population data. The pediatric population of Gipuzkoa seeking medical attention at one of the four Basque Country Health Service hospitals in the area: Hondarribia, Mendaro, San Sebastian and Zumarraga. The mean coverage in Gipuzkoa is 54,999 children aged less than 15 years/year. All the children aged 0-15 years old admitted for more than 24 h with a discharge diagnosis of varicella complications. The variables studied are: age, gender, personal history, varicella immunization, immune status, fever, chest X-ray, complementary investigations, length of hospital stay, treatment, discharge diagnosis, clinical course, complications and sequelae at discharge. RESULTS: Seventy-one children were hospitalized. None had been vaccinated against the varicella-zoster virus. Eighty percent were aged less than 5 years and three were immunocompromised. Fifty-six percent had bacterial superinfection and invasive forms were found in seven patients. The mean length of admission was 6.5 days +/- 5.1. No deaths or sequelae were reported. CONCLUSIONS: The annual incidence rate of admissions longer than 24 hours due to varicella complications was 12.9 cases per 100,000 children aged less than 15 years, representing 0.31% of all annual admissions in this age group.

Risk factors for hospitalization due to respiratory syncytial virus infection among infants in the Basque Country, Spain.

This study analysed the role of several risk factors for hospitalization due to community-acquired, respiratory syncytial virus (RSV) infection. The risk factors detected in infants hospitalized for RSV infection in the first 24 months of life were compared with those in the general infant population in our region. There were 361 episodes of hospitalization in 357 infants. Eighty per cent of the infants did not present underlying conditions for severe RSV infection and only 10 (3%) were candidates for palivizumab prophylaxis. In multivariate analysis, birthweight of <2500 g was independently associated with hospitalization for RSV infection and was the most commonly detected medical risk factor. Other risk factors were maternal age at delivery <25 years, birth in the second half of the year, prematurity, suburban residence and congenital heart disease. In conclusion, together with well-known risk factors, we found that low birthweight was an independent factor for severe RSV infection.

[Modulation of P-fimbriation by ciprofloxacin in uropathogenic Escherichia coli]. / Modulación de la fimbriación P por ciprofloxacina en Escherichia coli uropatógena.

BACKGROUND: The aim of this study was to determine the effect of ciprofloxacin at subinhibitory concentrations on the expression of P fimbriae of uropathogenic Escherichia coli. Thirty-nine strains of Escherichia coli isolated from out patients with urinary tract infection were studied. Thirty-nine of these strains had been previously characterized as P-fimbriated and the remaining non fimbriated strain was used as a negative control. METHODS: Fimbriation was quantitatively studied by electron microscope observation of the strains before and after treatment. To determine possible qualitative variations in the fimbrial proteins and in the external membrane (OMPs), extraction and electrophoretic separation was performed in polyacrylamide gels. RESULTS: No qualitative differences were observed in the OMPs profile and fimbrial proteins induced by ciprofloxacin in any of the strains studied. However, electron microscopic observation generally showed a decrease in the percentage fimbriated bacterial cells by the antimicrobial effect. CONCLUSIONS: The mechanism of action of ciprofloxacin at subinhibitory doses may correspond to a process of fimbrial protein synthesis inhibition secondary to the initiation of general repair mechanism of the cell exposed to the antimicrobial and not to a process of specific mutations which qualitatively affect fimbrial protein composition.

Hospitalizaciones por complicaciones de la varicela en niños menores de 15 años / Hospital admissions for varicella complications in children aged less than 15 years old

Antecedentes Las complicaciones por varicela se consideran una de las indicaciones que apoyan la cobertura vacunal universal. Objetivo Describir las complicaciones por varicela que han precisado hospitalización en una población definida (Guipuzkoa, España) y comparar la incidencia de hospitalizaciones con otras series. Material y métodos Estudio multicéntrico, retrospectivo, observacional, por revisión de historias clínicas, codificadas como varicela (CMBD, CIE-9, códigos 052.0-052.9) desde 1 de enero de 1993 a 31 de diciembre de 2002, y cálculo de las tasas de hospitalización en base a las urgencias asistidas y a los datos poblacionales. Población infantil de Guipuzkoa (España) asistida en el ámbito geográfico de los servicios de pediatría de los hospitales de agudos de Osakidetza-Servicio Vasco de Salud de Hondarribia, Mendaro, San Sebastián y Zumárraga, con una cobertura poblacional media de 54.999 niños menores de 15 años por año. Todos los niños y niñas de 0 a 15 años de edad, hospitalizados más de 24 h con el diagnóstico de varicela complicada. Se estudiaron las siguientes variables: edad, sexo, antecedentes personales, vacuna antivaricela, estado inmunológico, fiebre, radiografía de tórax, exámenes complementarios, duración del ingreso, tratamiento, diagnósticos de alta, evolución, complicaciones y secuelas al alta. Resultados Ingresaron 71 niños no vacunados frente al virus varicela-zoster, 80 por ciento menores de 5 años de edad, 68 inmunocompetentes y 3 no inmunocompetentes. Han predominado las sobreinfecciones bacterianas (56 por ciento) y destacan 7 casos con enfermedad invasiva. La estancia media ha sido de 6,50 5,15 día, sin mortalidad y sin secuelas. Conclusiones La incidencia anual de ingresos hospitalarios por varicela complicada superiores a 24 h ha sido 12,90 casos por cada 100.000 menores de 15 años, lo cual representa el 0,31 por ciento de los ingresos anuales hospitalarios en ese grupo (AU)