ABSTRACT
The 2019 coronavirus disease pandemic can have an alarming impact on vaccination coverage. WHO, UNICEF and Gavi warn that at least 80 million children under the age of 1 are at risk of contracting diseases such as diphtheria, measles and polio due to the interruption of routine immunization and the temporary suspension of 93 campaigns of large-scale vaccination.In Spain, a new healthcare scenario, which prioritizes telematics over in person, fear of contagion by going to health centers, and recommendations for physical distance and restricted mobility, reduce attendance at primary care centers. Despite recommendations established by the health authorities, vaccination coverage has decreased in all Autonomous Communities between 5% and 60%, depending on the age and type of vaccine. School vaccinations have been suspended and only vaccination of pregnant women against tetanus, diphtheria and pertussis has been maintained. The decrease has been more evident for non gratuity vaccines: the first dose of meningococcal vaccine B has decreased by 68.4% in the Valencian Community, and Andalusia has observed a 39% decrease in the total doses of this vaccine and of 18% for that of rotavirus.The recovering of vaccinations should be planned, organized and carried out in the shortest possible time.This article discusses some aspects of the recovery of vaccination coverage for different groups: children, adolescents and adults, and patients at risk and in special situations.
ABSTRACT
Skin infections are a common cause for dermatological consultations in the paediatric setting. A review is presented of the clinical manifestations, diagnosis and treatment of the main bacterial skin infections, as well as the diagnosis and treatment of super-infected puncture and bite wounds. The most prevalent bacteria in skin infections are Staphylococcus aureus and Streptococcus pyogenes. Treatment is usually empirical, since microbiological studies are only recommended under certain circumstances or lack of improvement with common therapies. Superficial skin infections can be treated with local antiseptics or antibiotics (mupirocin or fusidic acid). Systemic treatment is usually reserved for patients with extensive or severe disease or with other risk factors. Systemic treatment depends on the suspected infecting bacteria, with penicillin, amoxicillin, amoxicillin-clavulanic acid and first or second generation cephalosporin being the most frequently used drugs. Due to the low incidence of community-acquired methicillin-resistant infection by S. aureus in Spain, the use of clindamycin or co-trimoxazole is only recommended after severe disease, relapses or a clear epidemiological background.
Subject(s)
Staphylococcal Skin Infections/diagnosis , Staphylococcal Skin Infections/therapy , Streptococcal Infections/diagnosis , Streptococcal Infections/therapy , Anti-Bacterial Agents/therapeutic use , Clindamycin/therapeutic use , Community-Acquired Infections/drug therapy , Consensus , Humans , Outpatients , Pediatrics , Spain , Staphylococcus aureus , Streptococcus pyogenesABSTRACT
INTRODUCTION AND OBJECTIVES AND AIMS: Invasive meningococcal disease (IMD) remains a serious public health problem. Although culture is the gold standard, previous antibiotic therapy reduces its sensibility. The aim of this study is the epidemiological analysis of IMD in our area, to assess the usefulness of polymerase chain reaction (PCR) to increase its diagnostic accuracy,and to show the association of antibiotic administration with the negative result of the culture. PATIENTS AND METHODS: A retrospective study was conducted on all children younger than 16 years with microbiologically (positive culture and/or PCR) confirmed IMD, admitted to our hospital between 2004-2012. RESULTS: Seventy-five patients were included, of whom 52% had sepsis, 30.7% meningitis, and 17.3% with both of them. PCR was positive in all samples, whereas a positive was seen 50.7% of the cultures. Previously administered antibiotic was documented in 40 patients (53.3%), and 40% of them were confirmed by PCR only. CONCLUSIONS: PCR was the only test providing evidence for IMD diagnosis and serogroup determination in almost 39% of cases.
Subject(s)
Meningococcal Infections/diagnosis , Polymerase Chain Reaction , Child, Preschool , Female , Humans , Infant , Male , Meningococcal Infections/epidemiology , Retrospective StudiesABSTRACT
Introducción: La fiebre entérica (término que incluye la fiebre tifoidea y paratifoidea) es una infección sistémica causada por Salmonella typhi y Salmonella paratyphi. En los países desarrollados, la fiebre entérica dejó de ser endémica para convertirse en una enfermedad frecuentemente asociada a los viajes a zonas endémicas. Pacientes y métodos: Revisión de los casos de fiebre entérica confirmados por hemocultivo, en el periodo comprendido entre el 1 de enero de 2009 y el 31 de diciembre de 2010. Resultados: Se recogieron cuatro casos: fiebre tifoidea en una niña de 12 años natural de Pakistán y en una niña de 13 años originaria de la India que residían en Barcelona y viajaron en vacaciones a su país de origen; fiebre paratifoidea en un niño inmigrante procedente de Senegal, y fiebre paratifoidea en un lactante asociada a una tortuga como vector de transmisión. En todos ellos la fiebre se presentó como síntoma y signo principal de la enfermedad. Todos respondieron bien al tratamiento con amoxicilina-ácido clavulánico. Ningún paciente presentó complicaciones graves. Discusión: Los niños inmigrantes que viajan a sus países de origen para visitar a amigos y familiares presentan un mayor riesgo de enfermar. Los reptiles, portadores habituales de diferentes serovariedades de Salmonella, pueden actuar como posibles vectores de transmisión(AU)
Introduction: Enteric fever (term including typhoid and paratyphoid fever) is a systemic infection caused by Salmonella typhi and Salmonella paratyphi. In developed countries, enteric fever is no longer an endemic disease and has become an infection frequently related to travel to endemic areas. Patients and methods: Review of cases of enteric fever confirmed by blood culture, during the period from January 1st2009 to December 31st 2010.Results: We present four cases: typhoid fever in a 12-yearold girl native of Pakistan and in a 13-year old girl from India, who both lived in Barcelona and traveled on vacation to their country of origin; paratyphoid fever in an immigrant child from Senegal and paratyphoid fever in an infant with a turtle as the vector of transmission. In all cases, fever was the main symptomand sign of the disease. All responded well to treatment with amoxicillin-clavulanate. None of the patients had serious complications. Discussion: Immigrant children who travel to their countries of origin to visit friends and/or relatives are at increased risk of disease. Reptiles, which are common carriers of different Salmonella serovars, may act as potential transmission vector(AU)
Subject(s)
Humans , Male , Female , Child , Typhoid Fever/epidemiology , Typhoid Fever/prevention & control , Paratyphoid Fever/epidemiology , Paratyphoid Fever/prevention & control , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Spain/epidemiology , Salmonella typhi/isolation & purification , Salmonella paratyphi C/isolation & purification , Salmonella paratyphi A/isolation & purification , Salmonella paratyphi B/isolation & purification , Cefotaxime/therapeutic useABSTRACT
No disponible
Subject(s)
Humans , Female , Infant , Meningococcal Infections/etiology , Neisseria meningitidis/pathogenicity , Meningococcal Infections/drug therapySubject(s)
Humans , Male , Child , Equatorial Guinea/ethnology , Splenomegaly/diagnosis , Splenomegaly/pathology , Splenomegaly/therapy , Equatorial Guinea/epidemiology , Splenomegaly/blood , Splenomegaly/complications , Splenomegaly/ethnology , Splenomegaly/epidemiology , Splenomegaly/etiology , SplenomegalySubject(s)
Malaria , Splenomegaly/parasitology , Child , Equatorial Guinea , Humans , Malaria/immunology , Male , Splenomegaly/immunologyABSTRACT
El objetivo de este trabajo ha sido comparar dos pautas de tratamiento con dexametasona en el tratamiento de la meningitis neumocócica: una pauta corta de 48h y una larga de 96h. Estudio retrospectivo en el que se comparan dos pautas de tratamiento con dexametasona en una serie de 18 casos de meningitis neumocócica. Se observa una mayor duración de la fiebre primaria en el grupo que recibe la pauta corta de dexametasona estadísticamente significativa sin diferencias en cuanto al desarrollo de fiebre secundaria y en la evolución a muerte y/o secuelas neurológicas graves. Se concluye que no existen diferencias importantes entre las dos pautas de tratamiento y en la necesidad de desarrollar marcadores de mala evolución y nuevos tratamientos adyuvantes para mejorar el pronóstico de la enfermedad (AU)
Our aim was two compare two different dexamethasone administration schedules in pneumococcal meningitis: short course (48h) and long course (96h) treatment. We diagnosed 18 pneumococcal meningitis treated with the two different schedules. We found a statistically significant longer duration of primary fever in patients who received dexamethasone for two days. We found no differences in the appearance of secondary fever, or in the development of severe neurological handicaps, or death between the two groups. We conclude that they are no significant differences between the two treatment schedules and that there is a need for developing early prognostic markers and adjuvant therapies that improve the outcome of patients with pneumococcal meningitis (AU)
Subject(s)
Humans , /drug therapy , Dexamethasone/administration & dosage , Retrospective Studies , Fever/epidemiology , Chemotherapy, Adjuvant , Pneumococcal Infections/drug therapyABSTRACT
Our aim was two compare two different dexamethasone administration schedules in pneumococcal meningitis: short course (48h) and long course (96h) treatment. We diagnosed 18 pneumococcal meningitis treated with the two different schedules. We found a statistically significant longer duration of primary fever in patients who received dexamethasone for two days. We found no differences in the appearance of secondary fever, or in the development of severe neurological handicaps, or death between the two groups. We conclude that they are no significant differences between the two treatment schedules and that there is a need for developing early prognostic markers and adjuvant therapies that improve the outcome of patients with pneumococcal meningitis.
Subject(s)
Anti-Inflammatory Agents/administration & dosage , Dexamethasone/administration & dosage , Meningitis, Pneumococcal/drug therapy , Child , Child, Preschool , Drug Administration Schedule , Female , Humans , Infant , Male , Retrospective StudiesABSTRACT
El Staphylococcus aureus resistente a la meticilina adquirido en la comunidad (SARM-AC) es actualmente un microorganismo emergente en todo el mundo, que puede producir infecciones cutáneas y de partes blandas, algunas de éstas graves, como la fascitis necrosante, además de neumonía y osteomielitis. A continuación se presenta un caso de fascitis necrosante en un niño de 14 meses de edad, que se confirmó mediante resonancia magnética, producido por SARM-AC productor de leucocidina de Panton-Valentine. La evolución clínica fue buena después del tratamiento quirúrgico precoz y de la administración de clindamicina por vía intravenosa durante 2 semanas. En este trabajo se revisan los aspectos microbiológicos y las pautas de tratamiento de estas infecciones (AU)
Community-Acquired Methicillin-Resistant Staphylococcus aureus (CA-MRSA) is a worldwide emerging pathogen that is able to produce serious skin and soft- tissue infections such as necrotizing fasciitis, as well as pneumonia and osteomyelitis. We present a 14 month child with necrotizing fasciitis, confirmed by magnetic resonance imaging, produced by CA-MRSA Panton-Valentine leukocidin producer. The clinical outcome was good after early surgical treatment and the administration of intravenous clindamycin for two weeks. We review microbiological aspects and treatment guidelines of these infections (AU)
Subject(s)
Humans , Male , Infant , Fasciitis, Necrotizing/pathology , Staphylococcus aureus/pathogenicity , Methicillin Resistance , Community-Acquired Infections/epidemiology , Penicillin-Binding Proteins/immunology , Bacterial Toxins/immunology , Bacterial Toxins/toxicity , Anti-Bacterial Agents/therapeutic use , Magnetic Resonance Imaging/methods , Magnetic Resonance Imaging , Mupirocin/pharmacologyABSTRACT
Community-Acquired Methicillin-Resistant Staphylococcus aureus (CA-MRSA) is a worldwide emerging pathogen that is able to produce serious skin and soft- tissue infections such as necrotizing fasciitis, as well as pneumonia and osteomyelitis. We present a 14 month child with necrotizing fasciitis, confirmed by magnetic resonance imaging, produced by CA-MRSA Panton-Valentine leukocidin producer. The clinical outcome was good after early surgical treatment and the administration of intravenous clindamycin for two weeks. We review microbiological aspects and treatment guidelines of these infections.
Subject(s)
Bacterial Toxins/biosynthesis , Exotoxins/biosynthesis , Fasciitis, Necrotizing/microbiology , Leukocidins/biosynthesis , Methicillin-Resistant Staphylococcus aureus/metabolism , Staphylococcal Infections , Community-Acquired Infections , Humans , Infant , MaleABSTRACT
No disponible
Subject(s)
Humans , Male , Infant, Newborn , Streptococcus pneumoniae/isolation & purification , Bacteremia/complications , Bacteremia/diagnosis , Sepsis/complications , Sepsis/diagnosis , Meningitis/complications , Cefotaxime/therapeutic use , Muscle Hypotonia/complications , Hydrocephalus, Normal Pressure/complications , Electroencephalography , Endometritis/complicationsSubject(s)
Vaccines, Combined , Humans , Immunization Schedule , Spain , Vaccines, Combined/administration & dosageABSTRACT
No disponible
Subject(s)
Humans , Vaccines, Combined , Vaccines, Combined , Spain , Immunization Schedule , Immunization ScheduleABSTRACT
No disponible
