Follow-up for 3 years of a pediatric population diagnosed in 2018 with mother-to-child transmission of HIV in 8 Latin American countries in the PLANTAIDS cohort.

INTRODUCTION: The frequency of mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) in Latin America has decreased considerably. However, new infections continue to be recorded, and the pediatric population remains one of the most vulnerable groups in this region. The main objective of the study was to describe the clinical, epidemiological and psychosocial characteristics of new diagnoses of HIV MTCT in 2018 in the PLANTAIDS network (Paediatric Network for Prevention, Early Detection and Treatment of HIV in Children) during the 3 years following diagnosis. METHODOLOGY: Retrospective, multicenter, descriptive study based on a 3-year follow-up of patients diagnosed with HIV infection due to MTCT in 2018 in 10 hospitals in 8 Latin American countries (Costa Rica, Ecuador, Mexico, Honduras, El Salvador, Panama, Guatemala and Venezuela). The hospitals belonged to the PLANTAIDS network, which is included in CYTED (Ibero-American Programme of Science and Technology for Development). RESULTS: The study population comprised 72 pediatric patients (38.9% male). The median age at diagnosis was 2.4 years (IQR: 0.8-5.4). There were 35 cases of opportunistic infections corresponding to 25 patients (34.7%), with tuberculosis being the most common. Adequate childhood vaccination coverage was achieved in 80.5%. There were 3 cases of acute SARS-CoV-2 infection, and these were asymptomatic or mildly symptomatic. According to the Centers for Disease Control and Prevention (CDC) classification, the most frequent clinical-immunological stage at all check-ups was C1. Three patients died from opportunistic infections and/or advanced HIV infection. CONCLUSIONS: It is important to diagnose HIV infection early in pediatrics, since early initiation of ART is associated with a decrease in mortality. Despite this, HIV infection has a poor prognosis in children, necessitating adequate follow-up to ensure adherence to health care and ART, although it can sometimes prove difficult in children.

Colistina intraventricular en infección postoperatoria por Pseudomonas aeruginosa multiresistente:Reporte de un caso / Intraventricular Colistin in postoperative infection by resistant Pseudomonas aeruginosa: Report of a pediatric case.

Introducción: El surgimiento de bacterias Gram negativas multirresistentes y la aparición de infecciones post quirúrgicas, ha representado un desafío en el manejo antimicrobiano. Las características estructurales de estas bacterias, la formación de biofilms en los dispositivos internos y la presencia de infecciones en órganos de difícil acceso antimicrobiano como el sistema nervioso central, ha obligado a retomar el uso de antibióticos como Colistina por vías de administración poco utilizadas. Caso clínico: Presentamos el caso clínico de un paciente de 2 años de edad con meningo-ventriculitis postquirúrgica causada por Pseudomonas aeruginosa multirresistente manejado con tratamiento combinado de Colistina intraventricular e intravenoso, resultando en éxito terapéutico para el paciente. No se reportó ninguna reacción adversa a la medicación local ni sistémica. Tampoco se reportó recaídas infecciosas posterior al alta. Conclusiones: Los aspectos claves en el manejo de este tipo de infecciones deben ser consideradas: eliminación de la derivación ventrículo peritoneal infectada, óptima cobertura antimicrobiana y elección de la vía de administración más efectiva.

Introduction: The emergence of multi-resistant Gram-negative bacteria and the emergence of post-operative infections has represented a challenge in antimicrobial management. The structural characteristics of these bacteria, the formation of biofilms in internal devices and the presence of infections in organs of difficult antimicrobial access such as the central nervous system, has forced to consider the use of antibiotics such as Colistine through little-used administration routes. Clinical case: We present the clinical case of a 2-year-old patient with post-surgical meningo-ventriculitis caused by multiresistant Pseudomonas aeruginosa managed with combined treatment of intraventricular and intravenous Colistin, resulting in therapeutic success for the patient. No adverse reaction to local or systemic medication was reported. No infectious relapses were reported after discharge. Conclusions: The key aspects in the management of this type of infection have been considered: elimination of the infected peritoneal ventricle derivation, optimal antimicrobial coverage and choice of the most effective route of administration.

Encefalitis viral: revisión de 83 casos postmortem / Viral encephalitis: review of 83 cases postmortem

Se analizan algunas características anatomoclínicas de 83 casos de encefalitis viral diagnosticados en autopsias pediátricas. La frecuencia global de esta patología es del 2.13% de los estudios postmortem y en la mitad de los casos responsables de la muerte. La causa más frecuente en prescolares y escolares es la rabia, mientras que en niños más pequeños, la etiología predominante es el sarampión, el herpes y el citomegalovirus. Un grupo importante por su frecuencia e interés epidemiológico es la encefalitis viral de etiología no determinada. Este grupo constituye el 20% de esta serie y la falta de identificación etiológica se debe en parte a la poca utilización de los recursos diagnósticos tanto serológico como de cultivo