RESUMO
Introducción: A nivel mundial se describe un incremento de las infecciones por Staphylococcus aureus (S. aureus) resistente a meticilina (SARM). El espectro clínico de la enfermedad incluye desde colonización nasal hasta infecciones superficiales e invasoras. Objetivo: Describir la frecuencia, características clínicas y factores de riesgo asociados a la enfermedad por SARM en menores de 15 años, establecer la prevalencia de colonización y la susceptibilidad a antimicrobianos de las cepas aisladas. Materiales y métodos: Estudio descriptivo. Se incluyó a sujetos con edades comprendidas entre 1 mes a 15 años de edad atendidos en el Hospital del Niño de Panamá con infección invasora o superficial por S. aureus entre el 1 de junio de 2009 al 30 de junio de 2010. El estado de portador fue evaluado a través de la realización de muestra nasal. Se analizaron variables epidemiológicas, clínicas, tratamiento de la enfermedad y patrones de resistencia antimicrobiana. Resultados: Cohorte constituida por 146 sujetos con infecciones por S. aureus, de los cuales el 8,9% (13/146) presentaron infección por SARM, 38,5% de los cuales fueron adquiridos en la comunidad. El 53,8% de los sujetos con SARM presentó infección invasora. No se identificaron factores de riesgo para el desarrollo de infecciones por SARM. La prevalencia de portador nasal fue del 8,3%. Las tasas de resistencia a eritromicina y clindamicina fueron de 15,4%. Conclusiones: La incidencia de infecciones por SARM fue baja comparada con otras regiones. Se recomienda la vigilancia epidemiológica activa a fin de establecer guías de tratamiento basadas en criterios epidemiológicos locales (AU)
Introduction: Infections due to methicillin-resistant Staphylococcus aureus (MRSA) are increasing worldwide. The clinical spectrum of the disease ranges from nasal colonization to superficial and invasive infections. Objectives: To describe the frequency, clinical characteristics and risk factors associated with MRSA disease in children under 15years old. To establish the prevalence of colonization and antimicrobial susceptibility of isolates. Material and methods: Retrospective study. Included subjects; aged 1 month to 15years old treated in the Hospital del Niño in Panama with invasive or superficial infection by S. aureus in the period from June 1, 2009 to June 30, 2010. Carrier status was assessed by performing nasal swabs. Demographic, clinical features, treatment of disease and antimicrobial resistance patterns. Results: A total of 146 subjects were collected with S.aureus infections, of which 8.9% (13/146) were infected by MRSA. Community-acquired MRSA accounted for 38.5% of the isolates. We did not identify any risk factors for developing MRSA infections. The prevalence of nasal carriage was 8.3%. The resistance rates to erythromycin and clindamycin were 15.4%. Conclusions: The incidence of MRSA infections was low compared with other regions. We recommend active surveillance in order to establish measures to prevent nosocomial infections and treatment guidelines based on local epidemiological criteria (AU)
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Infecções Estafilocócicas/epidemiologia , Resistência a Meticilina , Panamá/epidemiologia , Staphylococcus aureus/patogenicidade , Fatores de Risco , Indicadores de MorbimortalidadeRESUMO
INTRODUCTION: Infections due to methicillin-resistant Staphylococcus aureus (MRSA) are increasing worldwide. The clinical spectrum of the disease ranges from nasal colonization to superficial and invasive infections. OBJECTIVES: To describe the frequency, clinical characteristics and risk factors associated with MRSA disease in children under 15 years old. To establish the prevalence of colonization and antimicrobial susceptibility of isolates. MATERIAL AND METHODS: Retrospective study. Included subjects; aged 1 month to 15 years old treated in the Hospital del Niño in Panama with invasive or superficial infection by S. aureus in the period from June 1, 2009 to June 30, 2010. Carrier status was assessed by performing nasal swabs. Demographic, clinical features, treatment of disease and antimicrobial resistance patterns. RESULTS: A total of 146 subjects were collected with S.aureus infections, of which 8.9% (13/146) were infected by MRSA. Community-acquired MRSA accounted for 38.5% of the isolates. We did not identify any risk factors for developing MRSA infections. The prevalence of nasal carriage was 8.3%. The resistance rates to erythromycin and clindamycin were 15.4%. CONCLUSIONS: The incidence of MRSA infections was low compared with other regions. We recommend active surveillance in order to establish measures to prevent nosocomial infections and treatment guidelines based on local epidemiological criteria.
Assuntos
Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Testes de Sensibilidade Microbiana , Panamá/epidemiologia , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/efeitos dos fármacosRESUMO
Introducción: La enfermedad por Bordetella pertussis es un problema de salud pública a nivel mundial. Se estiman de 20 a 40 millones de casos y 200.000 a 400.000 muertes con un aumento en lactantes y adultos. Objetivo: Evaluar las características clinicoepidemiológicas de la enfermedad por B. pertussis en el Hospital del Niño de Panamá. Materiales y métodos: Estudio observacional-retrospectivo. Se revisaron los formularios de notificación obligatoria del Departamento de Epidemiología del hospital. Fueron seleccionados aquellos con diagnóstico de enfermedad por B. pertussis mediante reacción en cadena de la polimerasa (RCP) y cultivo. Resultados: De 759 notificaciones por sospecha de tosferina, se obtuvo la confirmación de 180 casos por RCP y cultivo. La tasa de hospitalización fue de 14,4 por 10.000 admisiones, siendo mayor en el grupo de (3 meses [42,76 por 10.000 admisiones]). El 75% ocurrió en sujetos de 3 meses. La cianosis, la leucocitosis y linfocitosis fueron los hallazgos característicos al comparar aquellos sujetos con enfermedad confirmada vs. descartada. El 75% de los de 3 meses no recibieron dosis de vacuna al momento de la admisión hospitalaria. El porcentaje de letalidad fue de un 8,3%, más de la mitad en los de 1 mes. Conclusiones: La enfermedad por B. pertussis es un problema importante en salud pública. La vacunación posparto se plantea como una estrategia para reducir la morbimortalidad en el grupo de lactantes menores de 3 meses de edad (AU)
Introduction: Bordetella pertussis (whooping cough) is a worldwide public health problem. It is estimated that there are about 20 to 40 million cases with 200,000-400,000 deaths and is increasing in infants and adults. Materials and methods: An observational, retrospective study was made. We reviewed the epidemiologic surveillance notification forms from 2001 to 2008 period at the Epidemiology Department of Hospital Del Niño, a tertiary paediatric reference centre in Panama City. All pertussis (whooping cough) cases confirmed by PCR and cultures were selected. Results: From a total of 759 notifications of suspected whooping cough cases, 180 confirmed cases using PCR and culture were analyzed for this study. The admission rate in all ages was 14.4/10,000 admissions, predominantly in ≤3 months with 42.76/10,000 admissions and which accounted for 75% of the cases. Cough was the most important symptom (91%). Cyanosis, leucocytosis and lymphocytosis were the most characteristic clinical findings when comparing positive pertussis with negative. More than two thirds of the subjects less than 3 months of age had not been vaccinated at the time of admission. The death rate was 8.3%, more than half of them in subjects less than 1 month of age. Conclusions: Whooping cough is an important public health problem. Post-partum vaccination could be a strategy to reduce morbidity and mortality in infants less than 3 months (AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Bordetella pertussis/isolamento & purificação , Bordetella pertussis/patogenicidade , Coqueluche/epidemiologia , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Reação em Cadeia da Polimerase/métodos , Indicadores de Morbimortalidade , Vacinação/tendências , Reação em Cadeia da Polimerase/estatística & dados numéricos , Reação em Cadeia da Polimerase/tendências , Estudos Retrospectivos , Sinais e Sintomas , Panamá/epidemiologia , Cianose/epidemiologia , Leucocitose/epidemiologiaRESUMO
INTRODUCTION: Bordetella pertussis (whooping cough) is a worldwide public health problem. It is estimated that there are about 20 to 40 million cases with 200,000-400,000 deaths and is increasing in infants and adults. MATERIALS AND METHODS: An observational, retrospective study was made. We reviewed the epidemiologic surveillance notification forms from 2001 to 2008 period at the Epidemiology Department of Hospital Del Niño, a tertiary paediatric reference centre in Panama City. All pertussis (whooping cough) cases confirmed by PCR and cultures were selected. RESULTS: From a total of 759 notifications of suspected whooping cough cases, 180 confirmed cases using PCR and culture were analyzed for this study. The admission rate in all ages was 14.4/10,000 admissions, predominantly in < or =3 months with 42.76/10,000 admissions and which accounted for 75% of the cases. Cough was the most important symptom (91%). Cyanosis, leucocytosis and lymphocytosis were the most characteristic clinical findings when comparing positive pertussis with negative. More than two thirds of the subjects less than 3 months of age had not been vaccinated at the time of admission. The death rate was 8.3%, more than half of them in subjects less than 1 month of age. CONCLUSIONS: Whooping cough is an important public health problem. Post-partum vaccination could be a strategy to reduce morbidity and mortality in infants less than 3 months of age.
Assuntos
Coqueluche/diagnóstico , Coqueluche/epidemiologia , Pré-Escolar , Feminino , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , Masculino , Panamá , Estudos Retrospectivos , Fatores de TempoRESUMO
BACKGROUND: Dengue is a serious emerging infectious disease and constitutes a major international health concern. MATERIAL AND METHODS: All reports of confirmed dengue infection in patients aged less than 18 years old between 2000 and 2005 were included. A confirmed diagnosis was established by culture of the virus within the first 3 days of symptom onset or by serologic assays 5-30 days after symptom onset. Clinical and epidemiological features were analyzed. RESULTS: A total of 457 patients were included (57.6 % female). The median age was 13 years (IQR 5 6). A greater number of cases were detected in urban areas and during the rainy season (May-November). Two epidemics were reported in 2001 (33.9 %) and the first eight months of 2005 (23.1 %). The most prevalent symptoms were fever (95.2 %), severe headache (74.2 %), chills (65.9 %), rash (63.5 %), myalgias (51.9 %) and retro-orbital pain (51.6 %). No significant differences were found between male and female patients. Significant differences in clinical features were found when the patients were divided into 3 groups; < 5 years old, 6-10 years old and > 10 years old. Fifty-three percent of the patients had had previous contact with a dengue-infected individual. There were 7 patients with dengue hemorrhagic fever, 4 of whom died. CONCLUSIONS: Dengue virus infection is still a major health problem in Panama. To achieve effective control of dengue, further epidemiological studies, such as our own, are needed to design appropriate preventive measures.
Assuntos
Dengue/epidemiologia , Adolescente , Criança , Feminino , Humanos , Masculino , Panamá/epidemiologiaRESUMO
Antecedentes El dengue es una enfermedad infecciosa emergente, considerada actualmente como un problema de salud pública mundial. Material y métodos Se incluyeron en el estudio todos los casos positivos de dengue confirmados de pacientes menores de 18 años, durante los años 2000-2005. En las muestras recibidas en los primeros 3 días de la enfermedad se aisló el virus mediante cultivo y en las recibidas entre los días 5-30 por serología. Se analizaron las características clínicas y epidemiológicas de los pacientes. Resultados Se incluyeron 457 pacientes (57,6 % niñas). La mediana de edad fue de 13 años (rango interquartílico 5 6). Se detectó un predominio de la infección en las zonas urbanas y en los meses de mayo-noviembre. Se registraron 2 epidemias en los años 2001 (33,9 %) y primeros 8 meses de 2005 (23,1 %). Las manifestaciones clínicas más frecuentes fueron: fiebre (95,2 %); cefalea (74,2 %); escalofríos (65,9 %); exantema (63,5 %); mialgias (51,9 %), y dolor retroorbitario (51,6 %). No se observaron diferencias significativas según el sexo pero sí al dividir a los pacientes en grupos de edad; menores de 5 años, 6-10 años y mayores de 10 años. En el 53,0 % de los pacientes se registró el antecedente de contacto con otro sujeto infectado en los 15 días previos. Se diagnosticaron 7 casos de dengue hemorrágico de los cuales cuatro murieron. Conclusiones En Panamá el dengue continúa siendo un importante problema de salud pública. Para conseguir un control efectivo de la infección es preciso realizar estudios epidemiológicos, que como el nuestro, contribuyan a diseñar estrategias preventivas adecuadas
Background Dengue is a serious emerging infectious disease and constitutes a major international health concern. Material and methods All reports of confirmed dengue infection in patients aged less than 18 years old between 2000 and 2005 were included. A confirmed diagnosis was established by culture of the virus within the first 3 days of symptom onset or by serologic assays 5-30 days after symptom onset. Clinical and epidemiological features were analyzed. Results A total of 457 patients were included (57.6 % female). The median age was 13 years (IQR 5 6). A greater number of cases were detected in urban areas and during the rainy season (May-November). Two epidemics were reported in 2001 (33.9 %) and the first eight months of 2005 (23.1 %). The most prevalent symptoms were fever (95.2 %), severe headache (74.2 %), chills (65.9 %), rash (63.5 %), myalgias (51.9 %) and retro-orbital pain (51.6 %). No significant differences were found between male and female patients. Significant differences in clinical features were found when the patients were divided into 3 groups; 10 years old. Fifty-three percent of the patients had had previous contact with a dengue-infected individual. There were 7 patients with dengue hemorrhagic fever, 4 of whom died. Conclusions Dengue virus infection is still a major health problem in Panama. To achieve effective control of dengue, further epidemiological studies, such as our own, are needed to design appropriate preventive measures
