Clinical-epidemiological characteristics and predictors of coronary complications in children of Argentina with Kawasaki disease Background: Kawasaki disease (EK) is an acute systemic vasculitis with a risk of developing coronary aneurysms. Aim: To describe the clinical and epidemiological characteristics of children with EK in Argentina and to analyse the risk factors for the development of coronary's complications (CC). Methods: Multicenter, retrospective, cross-sectional, observational and analytical study. It included patients younger than 18 years of age diagnosed with EK in hospitals in Argentina, between January the 1 st , 2010 and December the 31 th , 2013. Results: N = 193 subjects. Age: medium: 29 months. Total incidence 5 cases / 10,000 hospital discharges. CC was observed in 15.5% of patients. Increased risk factors for CC: Elevated number of days with fever at the time of treatment placement (p = 0.0033); Increased of: heart frequency (p = 0.0021), erythrosedimentation (ESR) (p = 0.005), C-reactive protein (CRP) (p < 0.0001), leukocytes (p = 0.0006), neutrophils (p = 0.0021); Decreased of hematocrit (p = 0.0007) and hemoglobin (p < 0.0001).Association with CC: non-coronary cardiological alterations (OR = 10,818); PCR greater than 68 mg /L (OR = 11,596); leukocytes greater than 20,000 / mm 3 (OR = 4.316); and ESR greater than 64 mm / 1 hour (OR = 4.267). Conclusion: The most frequent form of presentation was complete EK, the risk of CC was higher in males, younger than 5 years old, the risk factors (clinical and laboratory) were similar to those described in the literature.

IntroductionIn 2012, PCV13 was introduced into the National Immunization Program in Argentina, 2+1 schedule for children <2 years. Coverage rates for 1st and 3rd doses were 69% and 41.0% in 2012, 98% and 86% in 2013; 99% and 89% in 2014, respectively. The aims of this study were to evaluate impact of PCV13 on Consolidated Pneumonia (CP) and Pneumococcal Pneumonia (PP) burden, and to describe epidemiological-clinical pattern of PP during the three-year period following vaccine introduction.MethodsHospital-based study at 10 pediatric surveillance units in Argentina. CP and PP discharge rates per 10,000 hospital discharges were compared between the pre-vaccination period 2007–2011 (preVp), the year of intervention (2012) and the post-vaccination period 2013–2014 (postVp).ResultsSignificant reduction in CP and PP discharge rates was observed in patients <5 years [% reduction (95%CI)]: 10.2% (6.3; 14.0) in 2012 and 24.8% (21.3; 28.2) in postVp for CP discharge rate; 59.5% (48.0; 68.5) in 2012 and 68.8% (58.3; 76.6) in postVp for PP discharge rate. Significant changes were also observed in children ≥5 years, mainly in PP discharge rate. A total of 297 PP cases were studied; 59.3% male; 31.3% <2 years; 42.9% had received PCV13 in 2012 and 84.5% in posVp. Case fatality rate was 3.4%. PCV13 serotypes decreased from 83.0% (39/47) in 2012 to 64.2% (52/81) in postVp, p = 0.039.ConclusionsAfter PCV13 introduction, significant reduction in CP and PP discharge rates was observed in hospitalized children <5 years. In patients ≥5 years, PP discharge rate also decreased significantly.

Introduction. The current evidence indicates that the severity of the coronavirus disease 2019 (COVID-19) is lower in the pediatric population but local data are still limited. Objective: To characterize the clinical and epidemiological aspects of COVID-19 infection in patients younger than 18 years in Argentina. Population and methods. Cross-sectional, observational, and analytical study of confirmed COVID-19 patients aged 0-18 years seen between March 2020 and March 2021 at 19 referral children's hospitals of Argentina. A multivariate analysis was done to identify predictors of severe cases. Results. A total of 2690 COVID-19 cases were included: 77.7% lived in the Metropolitan Area of Buenos Aires; 50.1% were males; patients' median age was 5.6 years. Of them, 90% were seen during epidemiological weeks 20-47 of 2020; 60.4% had a history of contact with COVID-19 patients; and 96.6% in their family setting. Also, 51.4% had respiratory symptoms; 61.6%, general symptoms; 18.8%, gastrointestinal symptoms; 17.1%, neurological symptoms; 7.2%, other symptoms; and 21.5% were asymptomatic. In addition, 59.4% of patients were hospitalized and 7.4% had a severe or critical course. A total of 57 patients developed multisystem inflammatory syndrome. A history of asthma, bronchopulmonary dysplasia, congenital heart disease, moderate to severe malnutrition, obesity, chronic neurological disease and/or age younger than 6 months were independent predictors of severity. Living in a vulnerable neighborhood was a protective factor. Conclusions. More than half of cases referred a history of contact with COVID-19 patients in the family setting. Hospitalization was not based on clinical criteria of severity. Severity was associated with the presence of certain comorbidities.

No abstract

No abstract

Estudio multicéntrico de infecciones invasivas por Streptococcus pyogenes en niños de Argentina Multicenter study on invasive Streptococcus pyogenes infections in children in Argentina

The rate of CA-MRSA infection was high; the rate of hospitalization increased in the 2013-2014 period; the 2-4-year-old group was the most affected one. A higher case fatality risk was observed among patients > 8 years old and those with the clinical presentations of pneumonia, meningitis, and sepsis.

Background: Bacterial meningitis and encephalitis are lifethreatening infections, a delay in its treatment is associated with high mortality. In 2015, FDA approved the Multiplex PCR FilmArray™ meningitis/encephalitis syndromic panel (FA-MEP), and it is available in our hospital since 2019. Aim: To estimate the number of positive FA-MEP, to evaluate the correlation to conventional culture (CC) results and to describe if the FA-MEP technology allowed changes in the treatment. Methods: Retrospective analysis of children with meningitis, encephalitis and meningoencephalitis and pathological cerebrospinal fluid analysis between 2019-2021, who were subject to FA-MEP testing at the Pedro Elizalde Children´s Hospital. Results: 32 children, mean age: 48 months. 11 patients had positive FA-ME tests: 7 bacterial, 6 viral. 2 patients correlated with CC. Based on the FA-MEP results, treatment was adjusted in 2 bacterial meningitis and the duration of intravenous treatment was shortened. Discussion: Our study allowed to establish the etiology of 5 culture negative bacterial meningitis, (2 had prior antibiotics), administer chemoprophylaxis to close contacts, and to administer fewer doses of acyclovir. Conclusions: The FA-MEP allowed us to identify 5 bacterial meningitis that tested negative by CC and early adjustment of inappropriate empirical antibiotics and to shorten the duration of parenteral treatments.