Clinical-epidemiological study of Bordetella pertussis infection in the Gran Canaria island in the period, 2008-2016.

OBJECTIVE: Describe the epidemiological and clinical pattern of Bordetella pertussis infection (whooping cough) among hospitalised infants less than one year-old in a paediatric hospital in Gran Canaria. PATIENTS AND METHODS: A retrospective review of the patient hospital records was performed, and recording only those with a microbiological diagnosis of pertussis infection detected using polymerase chain reaction, from January 2008 to December 2016. RESULTS: A total of 110 patients were identified, of which 105 (95.4%) were less than 6 months old, and 59.1% were males. The annual incidence of hospital admissions was estimated between 13.7 and 425.0 cases per 100 000 infants <12 months old, with 2 peaks in 2011 and 2015. Household members were the main potential sources of infection. Main clinical features were pertussis cough associated with signs of catarrh, cyanosis, and lymphocytosis. Complications occurred in 15.4% of the patients (mainly pneumonia), but the outcome was favourable in all the cases. A lower age and non-vaccination were associated with an increased risk of developing complications (p < .05). Viral co-infection occurred in 31.6% of infants diagnosed with pertussis. CONCLUSIONS: The incidence of pertussis has increased in the last years in Gran Canaria, with a lower development of complications and mortality rates compared with the previous period. Lower age and non-vaccination status are considered risk factors for developing complications. Vaccination in pregnant women will probably lead to a decline in the incidence in the future, especially in infants younger than 6 months.

OBJETIVO: Describir el patrón epidemiológico y clínico de la infección por Bordetella pertussis (tosferina) en niños menores de un año hospitalizados en un hospital pediátrico de Gran Canaria. PACIENTES Y MÉTODOS: Se revisaron retrospectivamente las historias clínicas de los pacientes con diagnóstico microbiológico de infección por B. pertussis mediante reacción en cadena de la polimerasa, de enero de 2008 a diciembre de 2016. RESULTADOS: Se identificaron 110 pacientes, de los cuales 105 (95,4%) fueron menores de 6 meses y el 59,1% eran varones. La incidencia anual de hospitalización se estimó entre 13,7 y 425,0 casos por cada 100.000 lactantes menores de 12 meses, con 2 picos en 2011 y 2015. Los familiares cercanos fueron las principales fuentes de contagio potenciales. Las principales manifestaciones fueron la tos pertusoide asociada con signos catarrales, cianosis y linfocitosis. El 15,4% de los pacientes presentaron complicaciones (principalmente neumonía), pero la evolución fue favorable en todos los casos. La menor edad y la no vacunación se asociaron con un mayor riesgo de desarrollar complicaciones (p < 0,05). La coinfección viral ocurrió en el 31,6% de los pacientes diagnosticados de infección por B. pertussis. CONCLUSIONES: La incidencia de infección por B. pertussis ha aumentado en los últimos años en nuestra área, con un menor desarrollo de complicaciones y con tasas de mortalidad inferiores al período anterior. La menor edad y la no vacunación previa se consideran factores de riesgo para el desarrollo de complicaciones. La vacunación en mujeres embarazadas probablemente disminuirá la incidencia en el futuro, sobre todo en niños menores de 6 meses.

[Clinical-epidemiological study of Bordetella pertussis infection in the Gran Canaria island in the period, 2008-2016]. / Estudio clínico-epidemiológico de la infección por Bordetella pertussis en la isla de Gran Canaria en el período 2008-2016.

OBJECTIVE: Describe the epidemiological and clinical pattern of Bordetella pertussis infection (whooping cough) among hospitalised infants less than one year-old in a paediatric hospital in Gran Canaria. PATIENTS AND METHODS: A retrospective review of the patient hospital records was performed, and recording only those with a microbiological diagnosis of pertussis infection detected using polymerase chain reaction, from January 2008 to December 2016. RESULTS: A total of 110 patients were identified, of which 105 (95.4%) were less than 6 months-old, and 59.1% were males. The annual incidence of hospital admissions was estimated between 13.7 to 425.0 cases per 100,000 infants <12 months old, with 2peaks in 2011 and 2015. Household members were the main potential sources of infection. Main clinical features were pertussis cough associated with signs of catarrh, cyanosis, and lymphocytosis. Complications occurred in 15.4% of the patients (mainly pneumonia), but the outcome was favourable in all the cases. A lower age and non-vaccination were associated with an increased risk of developing complications (P<.05). Viral co-infection occurred in 31.6% of infants diagnosed with pertussis. CONCLUSIONS: The incidence of pertussis has increased in the last years in Gran Canaria, with a lower development of complications and mortality rates compared with the previous period. Lower age and non-vaccination status are considered risk factors for developing complications. Vaccination in pregnant women will probably lead to a decline in the incidence in the future, especially in infants younger than 6 months.

Meningitis aséptica en la población adulta. Etiología y utilidad de las técnicas moleculares en el manejo clínico del paciente / Aseptic meningitis in an adult population. Etiology and utility of molecular techniques in the clinical management of patients

Objetivos: El estudio describe las características clínicoepidemiológicas y la etiología de la meningitis aséptica aguda (MAA) y analiza el impacto de un resultado microbiológico en el manejo clínico del paciente. Pacientes y métodos Se incluyeron prospectivamente en el estudio los pacientes mayores de 14 años inmunocompetentes con un cuadro clínico compatible con MAA entre 2007 y 2010. Se investigó la presencia de enterovirus y herpesvirus en líquido cefalorraquídeo por técnicas de amplificación genómica. Se recogieron retrospectivamente los datos clinicoepidemiológicos. Resultados Se incluyeron 94 pacientes, de los que 84 se diagnosticaron de meningitis vírica (MV). La incidencia anual de MV varió desde 2,4 a 15,3 casos por 100.000 habitantes. En el 76,2% de los casos se diagnosticó un agente etiológico; 55 enterovirus, 4 VHS tipo 2, 3 VVZ, un VHS tipo 1 y un VEB. Un 45,2% de los pacientes ingresaron y el 65,8% de ellos recibieron tratamiento antibiótico. El 80% de los pacientes ingresados recibió el alta al informar de un resultado positivo y en el 94,1% se retiró el tratamiento antibiótico. El tiempo medio de hospitalización en estos pacientes fue de 2,8±2,9 días. Todos los pacientes sin resultado positivo durante el ingreso completaron el tratamiento antibiótico, y el tiempo medio de hospitalización fue de 11,6±4,6 días. Conclusione s La incidencia anual de la MAA es variable. Los enterovirus fueron los principales agentes etiológicos. Las pruebas moleculares permitieron el diagnóstico en el 76,2% de los casos. El 45,2% de los pacientes ingresaron y un resultado positivo permitió el alta en la mayoría de los casos, así como la retirada del tratamiento antibiótico (AU)

Objective: This study describes the epidemiological, clinical and microbiological features of acute aseptic meningitis (AAM) in an adult population, and evaluates the impact of microbiological results on the clinical management of patients. Patients and methods: Cases of AAM were prospectively collected between 2007 and 2010 among immunocompetent patients over 14 years-old. Enteroviruses and herpes viruses were determined using nucleicacids detection in CSF. Demographic and clinical data were retrospectively collected from medicalrecords. Results: A total of 94 patients were included, of whom 84 were diagnosed with viral meningitis (VM). The annual incidence of VM ranged from 2.4 to 15.3 cases per 100,000 inhabitants. An aetiological diagnosiswas obtained in 76.2% of the patients with VM, 55 enterovirus, 4 HSV-2, 3 VZV, one HSV-1, and one EBV. Forty (..) (AU)

[Aseptic meningitis in an adult population. Etiology and utility of molecular techniques in the clinical management of patients]. / Meningitis aséptica en la población adulta. Etiología y utilidad de las técnicas moleculares en el manejo clínico del paciente.

OBJECTIVE: This study describes the epidemiological, clinical and microbiological features of acute aseptic meningitis (AAM) in an adult population, and evaluates the impact of microbiological results on the clinical management of patients. PATIENTS AND METHODS: Cases of AAM were prospectively collected between 2007 and 2010 among immunocompetent patients over 14 years-old. Enteroviruses and herpes viruses were determined using nucleic acids detection in CSF. Demographic and clinical data were retrospectively collected from medical records. RESULTS: A total of 94 patients were included, of whom 84 were diagnosed with viral meningitis (VM). The annual incidence of VM ranged from 2.4 to 15.3 cases per 100,000 inhabitants. An aetiological diagnosis was obtained in 76.2% of the patients with VM, 55 enterovirus, 4 HSV-2, 3 VZV, one HSV-1, and one EBV. Forty five per cent of patients were admitted to hospital and 65.8% of them received antibiotic treatment. A positive result prompted immediate discharge of 80% of inpatients and discontinuation of antibiotic therapy in 94.1% of them. The median duration of admission to hospital in these patients was 2.8±2.9 days. Patients without available results during admission completed the antibiotic treatment, and the median hospital stay was 11.6±4.6 days. CONCLUSIONS: The annual incidence of AAM is variable. Enteroviruses were the main aetiological agent. Molecular tests revealed the aetiology in 76.2% of cases. Almost half of the patients required hospitalisation, and in these cases a positive result can lead to the immediate discharge of patients, and the diagnostic and therapeutic interventions can be reduced.