Congenital infection by cytomegalovirus in newborns with very low birth weight.

Not available.

Molecular epidemiology of carbapenemase encoding genes in A. baumannii-calcoaceticus complex infections in children: a systematic review.

Background: Acinetobacter baumannii-calcoaeticus complex is the leader pathogen for the World Health Organization's list due to the escalating prevalence of multidrug-resistant strains. Insights into the molecular characterization of carbapenemase genes in A. baumannii-calcoaceticus complex infections among children are scarce. To address this gap, we conducted a systematic review to describe the molecular epidemiology of the carbapenemase genes in A. baumannii-calcoaceticus complex infections in the pediatric population. Methods: Adhering to the PRISMA 2020 guidelines for reporting systematic reviews, we conducted a review of in chore bibliographic databases published in English and Spanish, between January 2020 and December 2022. All studies conducted in patients ≤6 years with molecular characterization of carbapenemase-encoding genes in A. baumannii-calcoaceticus infections were included. Results: In total, 1129 cases were reviewed, with an overall carbapenem-resistance rate of 60.3%. A. baumannii-calcoaceticus was isolated from blood cultures in 66.6% of cases. Regionally, the Eastern Mediterranean exhibited the highest prevalence of carbapenem resistance (88.3%). Regarding the carbapenemase genes, blaKPC displayed an overall prevalence of 1.2%, while class B blaNDM had a prevalence of 10.9%. Class D blaOXA-23-like reported a prevalence of 64%, blaOXA-48 and blaOXA-40 had a prevalence of 33% and 18.1%, respectively. Notably, the Americas region showed a prevalence of blaOXA-23-like at 91.6%. Conclusion: Our work highlights the high prevalence of carbapenem-resistant A. baumannii-calcoaceticus and class D carbapenemase genes in children. Of note the distribution of different carbapenemase genes reveals considerable variations across WHO regions. To enhance epidemiological understanding, further extensive studies in children are imperative.

[Bloodstream infections with Candida glabrata in a neonatal intensive care unit that uses prophylaxis with fluconazole]. / Infección del torrente sanguíneo por Candida glabrata en una unidad de cuidados intensivos neonatales con prescripción de profilaxis con fluconazol.

BACKGROUND: Candida glabrata is an emerging pathogen with the ability to develop tolerance and resistance to azole antifungals, which creates uncertainty about the usefulness of antifungal prophylaxis in newborns. AIMS: The aim of this study was to describe the factors associated with C. glabrata infection in a NICU that uses prophylaxis with fluconazole. METHODS: A case-control study paired by gestational age was designed and conducted at the Civil Hospital of Guadalajara Dr. Juan I. Menchaca. Newborns with C. glabrata infection were studied and for each one a matched control was selected by gestational age. Odds ratios (OR) were estimated with 95% confidence intervals (95% CI) and McNemar test for contrast of hypothesis was applied. RESULTS: Twenty-one infected patients were identified, from whom 66.7% were male; the median gestational age was 31.5 weeks. Increased risk of infection with C. glabrata was observed when there was a prescription of more than one antimicrobial scheme (OR 21, 95% CI, 1.23 - 358.3; p=0.006) and also among patients with surgical comorbidities (OR 8, 95% CI 1.01 - 63.9; p=0.04). During the study period, exposure to fluconazole showed no difference in the risk of infection. CONCLUSIONS: Neonates with more than one antimicrobial regimen and those with surgical comorbidities had a higher risk of C. glabrata infection.