COVID-19 admissions: Trying to define the real impact of infection in hospitalized patients.

INTRODUCTION AND OBJECTIVE: Several studies have suggested that the hospitalization rate for COVID-19 in children and adolescents may reflect the prevalence of the infection rather than the severity of the disease. The aim of this study was to describe the clinical features of hospitalised paediatric patients with SARS-CoV-2 infection in order to understand if the infection was the reason for admission. METHODS: Retrospective cohort study including patients aged 0-18 years with SARS-CoV-2 infection or multisystem inflammatory syndrome in children (MIS-C) admitted to a tertiary care children's hospital in Spain between 01/01/2020 and 12/31/2021. RESULTS: 228 patients were included, corresponding to 150 cases of COVID-related admission (SARS-CoV-2 infection as main cause of hospitalization) and 78 of non-COVID-related admission (SARS-CoV-2 infection unrelated to the hospitalization). In the group of COVID-related admissions, 58 patients had comorbidities. Forty-nine patients had acute respiratory disease (pneumonia, bronchospasm or bronchiolitis). Multisystem inflammatory syndrome in children was diagnosed in 27 and was significantly more frequent in the first year of the pandemic (wild type virus). Eighty percent of patients with acute respiratory disease needed respiratory support, mostly low-flow oxygen therapy. The severity of the disease was similar in all virus variants. Two patients (both with severe comorbidities) died from COVID-related conditions. CONCLUSIONS: In our study, one third of the patients were admitted with SARS-CoV-2 infection but not because of it. Acute respiratory disease was less frequent and had a better prognosis compared to the adult population, while MIS-C was a major cause of morbidity and hospitalization. The fatality rate was extremely low.

Infección respiratoria polimicrobiana: un caso de colonización multirresistente y coinfección viral en un lactante

Se presenta el caso de un lactante de 38 semanas ingresado con distrés respiratorio a un nosocomio al norte del Perú. Tras intubación y conexión a ventilación mecánica, se administró tratamiento antimicrobiano y sedoanalgesia. Durante la hospitalización, el paciente presentó fiebre, tos con expectoración quintosa, rubicundez facial y desaturación. Se observó edema en párpados, manos y pies, pero la perfusión tisular se mantuvo adecuada. En el cuarto día, sufrió convulsión febril, sibilancias respiratorias y oliguria con hematuria. Se realizaron cambios en el tratamiento y se administraron transfusiones. Al día 7, con apoyo del panel de PCR múltiple (FilmArray®) para el diagnóstico etiológico de enfermedades infecciosas respiratorias, se diagnosticó colonización/infección por Acinetobacter baumanni multirresistente, la cual se acompañó con la detección de Serratia marcescens y virus sincicial respiratorio. Tras una estancia prolongada se logró la extubación exitosa el día 10. El día 24, el paciente fue dado de alta sin fiebre, signos vitales estables y sin requerir oxígeno, solo tratamiento para las convulsiones.

A case is presented of a 38-week-old infant admitted with respiratory distress to a hospital in northern Perú. After intubation and connection to mechanical ventilation, antimicrobial treatment and sedoanalgesia were administered. During hospitalizaron, the patient experienced fever, cough with quintose expectoration, facial rubor, and desaturation. Edema was observed in the eyelids, hands, and feet, but tissue perfusion remained adequate. On the fourth day, the patient had a febrile seizure, respiratory wheezing, and oliguria with hematuria. Treatment changes were made, and transfusions were administered. On the seventh day, using the FilmArray® multiplex PCR panel for etiological diagnosis of respiratory infectious diseases, colonization/infection by multidrug-resistant Acinetobacter baumanni was diagnosed, accompanied by the detection of Serratia marcescens and respiratory syncytial virus. After a prolonged stay, successfu extubation was achieved on day 10. On day 24, the patient was discharged without fever, stable vital signs, and without requiring oxygen only treatment for seizures.

Características clínicas y epidemiológicas de la infección por Chlamydia trachomatis en pacientes de consultas de infecciones de transmisión sexual / Clinical and epidemiological characteristics of Chlamydia trachomatis infection among sexually transmitted infection clinics patients

Introducción: Las infecciones por Chlamydia trachomatis (CT) son un problema de salud pública por su alta incidencia y consecuencias sobre la salud reproductiva. Nuestro objetivo es describir las características sociodemográficas, conductuales y clínicas de los pacientes con infección por CT para adaptar las intervenciones preventivas a los grupos con mayor riesgo. Métodos: Serie de casos prospectiva de todos los pacientes diagnosticados de CT entre septiembre del 2016 a enero del 2019 en las consultas de referencia para infecciones de transmisión sexual (ITS) de Osakidetza en Bizkaia.Resultados: Aceptaron participar 847 pacientes (88,2%): 41% mujeres, 33,8% varones heterosexuales y 25% hombres que tenían sexo con hombres (HSH); 33% eran inmigrantes y 26% menores de 25 años (33% entre las mujeres). Un 20% utilizaba siempre preservativo. Un 36% había tenido ITS anteriormente y 28% tenía otra ITS simultánea. El 55% de las infecciones fueron asintomáticas (70% entre las mujeres). El recto fue la localización más frecuente entre los HSH (69,5%), seguida de la uretra (31,4%) y la faringe (14,5%). En las mujeres, la infección afectó principalmente el cérvix (86,5% de los casos), seguido del recto (17,6%) y la faringe (13,8%). Se estudió a los contactos del 58% de los pacientes. La tasa de reinfección a las cuatro semanas fue del 17% entre aquellos con criterios para realizar un test de cura.Conclusión: Estos resultados justifican la implantación de cribados oportunistas en mujeres menores de 25 años e inmigrantes jóvenes de ambos sexos, con toma de muestras genitales y extra-genitales, y el establecimiento de guías apropiadas para la notificación de contactos.(AU)

Background: Chlamydia trachomatis (CT) infections are a public health problem because of its high incidence and consequences on reproductive health. Our aim is to describe the socio-demographic, behavioral and clinical characteristics of patients with CT infection in order to adapt preventive interventions for the highest risk groups. Methods: Prospective case series of all patients diagnosed with CT between September 2016 and January 2019 in the reference STI clinics of Osakidetza (Basque Health Service) in Bizkaia (Spain). Results: 847 patients (88.2%) agreed to participate: 41% women, 33.8% heterosexual men and 25% men who has sex with men (MSM); 33% were immigrants and 26% were under the age of 25 (33% of the women). Only 20% systematically used condoms. 36% had previously had STI and 28% had simultaneously another STI. 55% of the infections were asymptomatic (70% among women). In MSM, the rectum was affected in 69.5% of cases, the urethra in 31.4%, and the pharynx in 14.5%. The cervix was affected in 86.5% of the women, the rectum in 17.6%, and the pharynx in 13.8%. A contact study was only carried out in 58% of cases. The reinfection rate at 4 weeks was 17% among those with criteria to perform a test of cure. Conclusion: Our results justify implement opportunistic screening in women under the age of 25 and young immigrants of both sexes, by taking genital and extragenital samples, as well as developing appropriate guidelines for the notification and follow-up of contacts.(AU)

Clinical and epidemiological characteristics of Chlamydia trachomatis infection among sexually transmitted infection clinics patients.

BACKGROUND: Chlamydia trachomatis (CT) infections are a public health problem because of its high incidence and consequences on reproductive health. Our aim is to describe the socio-demographic, behavioral and clinical characteristics of patients with CT infection in order to adapt preventive interventions for the highest risk groups. METHODS: Prospective case series of all patients diagnosed with CT between September 2016 and January 2019 in the reference STI clinics of Osakidetza (Basque Health Service) in Bizkaia (Spain). RESULTS: 847 patients (88.2%) agreed to participate: 41% women, 33.8% heterosexual men and 25% men who has sex with men (MSM); 33% were immigrants and 26% were under the age of 25 (33% of the women). Only 20% systematically used condoms. 36% had previously had STI and 28% had simultaneously another STI. 55% of the infections were asymptomatic (70% among women). In MSM, the rectum was affected in 69.5% of cases, the urethra in 31.4%, and the pharynx in 14.5%. The cervix was affected in 86.5% of the women, the rectum in 17.6%, and the pharynx in 13.8%. A contact study was only carried out in 58% of cases. The reinfection rate at 4 weeks was 17% among those with criteria to perform a test of cure. CONCLUSION: Our results justify implement opportunistic screening in women under the age of 25 and young immigrants of both sexes, by taking genital and extragenital samples, as well as developing appropriate guidelines for the notification and follow-up of contacts.

Factores de riesgo asociados a infección de catéter de hemodiálisis en un centro de referencia

RESUMEN Introducción: la infección asociada a catéter de hemodiálisis es una causa importante de morbimortalidad en los pacientes que requieren hemodiálisis de manera permanente, elevando el riesgo de mortalidad 2 veces más de los que no lo tienen. Por esto resulta imprescindible determinar los factores predisponentes a adquirir esta infección. Objetivos: determinar los factores de riesgo asociados a la infección del catéter de hemodiálisis de los pacientes en el Hospital Nacional de Itauguá. Métodos: se realizó un estudio observacional de casos y controles de 104 pacientes, 52 pacientes como casos y 52 como controles. Resultados: se analizaron las siguientes variables cualitativas como factores de riesgo: desconocimiento del cuidado del catéter (OR: 9,66; p: 0,05), hipertensión arterial (OR: 1,17; p: >0,05) ausencia de infección previa (OR: 2,25; p: <0,05), procedencia rural (OR: 2,67; p: <0,05), ubicación del catéter femoral (OR: 6,51; p: <0,05), colonización con Staphylococcus aureus (OR: 15,6; p: <0,05), curación única semanal (OR: 37,40; p: <0,05) y escolaridad primaria (OR: 2,93; p: <0,05). En cuanto a las variables cuantitativas se analizaron la edad (p: <0,05), tiempo de instalación del catéter (p: <0,05) y tiempo de evolución de la hemodiálisis (p: 0,2) Conclusión: se asociaron de manera significativa a la infección de catéter de hemodiálisis el desconocimiento del cuidado del catéter, la ausencia de turno fijo trisemanal, la procedencia rural, la colonización con Staphylococcus aureus, la curación una vez por semana del catéter y la escolaridad primaria, la edad mayor a 51 años y la instalación reciente del catéter.

ABSTRACT Introduction: Hemodialysis catheter-associated infection is an important cause of morbidity and mortality in patients who require permanent hemodialysis, raising the risk of mortality two times more than those who do not. For this reason, it is essential to determine the predisposing factors to acquire this infection. Objectives: To determine the risk factors associated with hemodialysis catheter infection in patients at the Hospital Nacional of Itauguá. Methods: An observational case-control study of 104 patients was carried out, 52 patients as cases and 52 as controls. Results: The following qualitative variables were analyzed as risk factors: lack of knowledge of catheter care (OR: 9.66; p: 0.05), arterial hypertension (OR: 1.17; p: >0.05), absence of previous infection (OR: 2.25; p: <0, 05), rural origin (OR: 2.67; p: <0.05), femoral catheter location (OR: 6.51; p: <0.05), colonization with Staphylococcus aureus (OR: 15.6; p: <0.05), single weekly cure (OR: 37.40; p: <0.05) and primary education (OR: 2.93; p: <0.05). Regarding the quantitative variables, age (p: <0.05), time of catheter installation (p: <0.05) and time of evolution of hemodialysis (p: 0,2) were analyzed. Conclusion: Ignorance of catheter care, absence of three-week fixed shift, rural origin, colonization with Staphylococcus aureus, catheter healing once a week, primary education, age over 51 years and recent catheter installation were significantly associated with hemodialysis catheter infection.

Clinical and epidemiological characteristics of Chlamydia trachomatis infection among sexually transmitted infection clinics patients. / Características clínicas y epidemiológicas de la infección por Chlamydia trachomatis en pacientes de consultas de infecciones de transmisión sexual.

BACKGROUND: Chlamydia trachomatis (CT) infections are a public health problem because of its high incidence and consequences on reproductive health. Our aim is to describe the socio-demographic, behavioral and clinical characteristics of patients with CT infection in order to adapt preventive interventions for the highest risk groups. METHODS: Prospective case series of all patients diagnosed with CT between September 2016 and January 2019 in the reference STI clinics of Osakidetza (Basque Health Service) in Bizkaia (Spain) RESULTS: 847 patients (88.2%) agreed to participate: 41% women, 33.8% heterosexual men and 25% men who has sex with men (MSM); 33% were immigrants and 26% were under the age of 25 (33% of the women). Only 20% systematically used condoms. 36% had previously had STI and 28% had simultaneously another STI. 55% of the infections were asymptomatic (70% among women). In MSM, the rectum was affected in 69.5% of cases, the urethra in 31.4%, and the pharynx in 14.5%. The cervix was affected in 86.5% of the women, the rectum in 17.6%, and the pharynx in 13.8%. A contact study was only carried out in 58% of cases. The reinfection rate at 4 weeks was 17% among those with criteria to perform a test of cure. CONCLUSION: Our results justify implement opportunistic screening in women under the age of 25 and young immigrants of both sexes, by taking genital and extragenital samples, as well as developing appropriate guidelines for the notification and follow-up of contacts.

SARS-CoV-2 y RT-PCR en pacientes asintomáticos: resultados de una cohorte de trabajadores del Aeropuerto Internacional El Dorado de Bogotá, 2020 / SARS-CoV-2 and RT-PCR in asymptomatic patients: Results of a cohort of workers at El Dorado International Airport in Bogotá, 2020

Introducción. La pandemia de COVID-19 ha ocasionado cerca de 25 millones de casos en el mundo. Se ha descrito que los pacientes asintomáticos pueden ser fuentes de transmisión. Sin embargo, es difícil detectarlos y no es claro su papel en la dinámica de transmisión del virus, lo que obstaculiza la implementación de estrategias para la prevención. Objetivo. Describir el comportamiento de la infección asintomática por SARS-CoV-2 en una cohorte de trabajadores del Aeropuerto Internacional El Dorado "Luis Carlos Galán Sarmiento" de Bogotá, Colombia. Materiales y métodos. Se diseñó una cohorte prospectiva de trabajadores del Aeropuerto El Dorado. El seguimiento se inició en junio de 2020 con una encuesta a cada trabajador para caracterizar sus condiciones de salud y trabajo. Cada 21 días se tomó una muestra de hisopado nasofaríngeo para detectar la presencia del SARS-CoV-2 mediante reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR). Se analizó el comportamiento del umbral del ciclo (cycle threshold) de los genes ORFlab y N según el día de seguimiento. Resultados. En los primeros tres seguimientos de la cohorte se encontró una incidencia de la infección por SARS-CoV-2 del 16,51 %. La proporción de contactos positivos fue del 14,08 %. La mediana del umbral del ciclo fue de 33,53. Conclusión. Se determinaron las características de la infección asintomática por el SARS-CoV-2 en una cohorte de trabajadores. La detección de infectados asintomáticos sigue siendo un reto para los sistemas de vigilancia epidemiológica.

Introduction: The 2019 coronavirus pandemic (COVID-19) has caused around 25 million cases worldwide. Asymptomatic patients have been described as potential sources of transmission. However, there are difficulties to detect them and to establish their role in the dynamics of virus transmission, which hinders the implementation of prevention strategies. Objective: To describe the behavior of asymptomatic SARS-CoV-2 virus infection in a cohort of workers at the El Dorado "Luis Carlos Galán Sarmiento" International Airport in Bogotá, Colombia. Materials and methods: A prospective cohort of 212 workers from the El Dorado airport was designed. The follow-up began in June, 2020. A survey was used to characterize health and work conditions. Every 21 day, a nasopharyngeal swab was taken to identify the presence of SARS-CoV-2 using RT-PCR. We analyzed the behavior of the cycle threshold (ORFlab and N genes) according to the day of follow-up. Results: In the first three follow-ups of the cohort, we found an incidence of SARS-CoV-2 infection of 16.51%. The proportion of positive contacts was 14.08%. The median threshold for cycle threshold was 33.53. Conclusion: We characterized the asymptomatic SARS-CoV-2 infection in a cohort of workers. The identification of asymptomatic infected persons continues to be a challenge for epidemiological surveillance systems.

Susceptibilidad antibiótica de Staphylococcus aureus de aislados nasales en estudiantes del norte de Perú / Antibiotic susceptibility of Staphylococcus aureus from nasal isolates in students from northern Peru

Objetivos: determinar el perfil de susceptibilidad antibiótica de Staphylococcus aureus, en estudiantes de Biología, Enfermería y Medicina de la Universidad Nacional Pedro Ruiz Gallo-Lambayeque. Métodos: Las muestras fueron recolectadas mediante hisopados nasales. Se realizó el aislamiento primario en Agar Manitol Salado, para la recuperación e identificación de Staphylococcus aureus de octubre 2015- marzo 2016. La prueba de susceptibilidad bacteriana se realizó la prueba de sensibilidad antimicrobiana por el método de disco de difusión. Resultados: se aislaron 43 cultivos positivos para Staphylococcus aureus, lo cual representó el 28,6%; siendo negativas 107 muestras, representando el 71,4%. Se determinó que, el 90,6% de las cepas fueron resistentes a Oxacilina, el 81,3 % a Sulfametoxazol - Trimetoprima, el 95,3 % a Penicilina, el 34,8% a Cefoxitina, siendo todas las cepas 100% sensibles a Imipenem y Vancomicina. La evaluación de la reacción cruzada dio como resultado que el 2.6% de las cepas presentaron resistencia a Ceftazidima, 12,8% a Azitromicina, el 15,4 % a Cefotaxima, y el 20,9% a Gentamicina; por el contario fueron 100% sensibles a Amikacina, Ciprofloxacino, Ceftriaxona y Cefuroxima. Conclusiones: El 28,6% del total de la población en estudio dio positiva para Staphylococcus aureus, el 90,6 % de las cepas de fueron resistentes a Oxacilina, siendo todas las cepas sensibles a Imipenem. La Escuela profesional de Ciencias Biológicas fue quien presentó mayor frecuencia de aislamientos de Staphylococcus aureus.

Objectives: To determine the antibiotic susceptibility profile of Staphylococcus aureus, in Biology, Nursing and Medicine students of the Pedro Ruiz Gallo-Lambayeque National University. Methods: Samples were collected by means of nasal swabs. Primary isolation was performed on Salt Mannitol Agar, for the recovery and identification of Staphylococcus aureus from October 2015 to March 2016. The bacterial susceptibility test was performed by the antimicrobial sensitivity test by the diffusion disc method. Results: 43 positive cultures were isolated for Staphylococcus aureus, which represented 28.6%; 107 samples were negative, representing 71.4%. It was determined that, 90.6% of the strains were resistant to Oxacillin, 81.3% to Sulfamethoxazole - Trimethoprim, 95.3% to Penicillin, 34.8% to Cefoxitin, being all strains 100% sensitive to Imipenem and Vancomycin. Evaluation of the cross reaction resulted in 2.6% of the strains showing resistance to Ceftazidime, 12.8% to Azithromycin, 15.4% to Cefotaxime, and 20.9% to Gentamicin; on the contrary they were 100% sensitive to Amikacin, Ciprofloxacin, Ceftriaxone and Cefuroxime. Conclusions: 28.6% of the total population in the study was positive for Staphylococcus aureus, 90.6% of the strains were resistant to Oxacillin, and all the strains were sensitive to Imipenem. The Professional School of Biological Sciences presented the highest frequency of Staphylococcus aureus isolates.

[Respiratory viral infections in a cohort of children during the first year of life and their role in the development of wheezing]. / Infecciones virales respiratorias en una cohorte de niños durante el primer año de vida y su papel en el desarrollo de sibilancias.

INTRODUCTION: It is known that infants with viral respiratory infections severe enough to require hospital admission have a high risk of developing recurrent wheezing. Few data have been published on unselected populations. The main aim of this study was to analyse symptomatic and asymptomatic respiratory viral infections during the first year of life in a cohort of infants, recruited at birth, and the development of recurrent wheezing. PATIENTS AND METHODS: A total of 302 newborns were recruited. A nasopharyngeal aspirate was taken when the patients had a respiratory infection, as well as in the visits for vaccination at 2, 4, 6, and 12 months. RT-nested PCR assays were performed to detect 16 viruses. RESULTS: A total of 1,293 samples were analysed (1,005 healthy controls and 288 respiratory infections). Samples taken during routine check-ups were positive in 30.8% of cases, while those with respiratory infection were positive in 77.8%, P<.001 (OR: 3, 95% CI: 2.4-3.8). A total of 239 (79%) infants had at least 1 positive respiratory viral infection detected. The most frequent virus (71%) was rhinovirus (RV). Recurrent wheezing was found in 27 (11%) children during their first year of life (1.2 episodes, SD 2.9). Recurrent wheezing was present in 58.3% of patients admitted to hospital during their first viral infection, vs. 8.6% of infants when the first infection was mild or who had asymptomatic viral detection, P<.001 (OR: 2.18; 95% CI: 1.05-4.5). CONCLUSIONS: In our series, severe respiratory infections leading to hospitalisation in the first months of life are risk factors for developing wheezing, but not in the case of mild RV infections.