The use of sulfomethate sodium colistin for the treatment of infections caused by multiple drug resistant (MDR) Gram-negative microorganisms were studied in a burn unit to evaluate the safety of this drug. A prospective chart review of pediatric patients treated with intravenous colistin in a tertiary burn unit between January 2005 and December 2006 was performed. Forty-five courses of intravenous colistin treatment administered to 45 children were evaluated in the study period. Fourteen patients (31%) were infected by Pseudomonas aeruginosa spp and 20 patients (44.5%) by Acinetobacter spp and an association of both bacteria was found in six patients (13.5%).The mean age of the patients was 52 months (range, 2 to 168 months), and 28 patients (62%) were men. The percentage of burnt body surface was between 9 and 87% (mean, 38%). Forty patients (89%) were infected by MDR organisms. Colistin was empirically indicated in five patients (11%) with burn wound sepsis 7 days after admission to the unit despite negative cultures. Burn wound sepsis was the most frequent focus of infection in 19 patients (42%). In 14 patients (31%), burn wound infection occurred without sepsis. Intravascular catheter-related bacteremia occurred in three patients (7%) and bacteremia in one (2%). Three patients had pneumonia (7%), three osteomyelitis (7%), and two urinary tract infection (4%).The length of treatment with colistin was between 3 and 92 days (median, 21 days). Only one patient (2%) died for reasons other than infection. None of the children developed increases in serum creatinine concentrations or neurological complications during treatment with colistin. Colistin seems to be a safe drug in selected cases of infections with MDR Gram-negative microorganisms. Further studies are needed to confirm these results.

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Osteoarticular infection is unusual in the neonate; however it is associated with an elevated incidence of sequelae. This mandates for a high degree of suspicion to diagnose this potentially disabling entity.

Infections after cardiovascular surgery are an important cause of morbidity and mortality. This paper described the study of risk factors associated with development of infections. This is a prospective study, setting in a Hospital JP Garrahan, a tertiary and referral center of Buenos Aires, Argentina. All patients with cardiac surgeries between 1/ 11/01 to 1/1/ 2002 were included. The median age of p was 30 months (r: 1-212 m), 184 p (53%) were boys, 21% (75) had underlying disease, being the genetic disorders or undernutrition the most frequent, 56 p (16%) had previous surgery, 36 p (10%) had received previous antibiotics and 30 (9%) of them had previous infection, An ASA score higher than or equal to 3 was found in 308 p (88%). Median hospital stay before surgery was 1 day (r1-120 d), 88 p (25%) nedeed inotropic support with epinephrine, 147 p (42%) needed mechanical ventilation during a median time of 4 days (r: 1-66d).Drainage with thorax opened was done in 339p (97%) for a median time of 2 days (r:1-7d). Total hospital stay was between 1 and 120 days (median 5 days). Postsurgical infections developed in 38 of 350p (11%). Superficial wound infection in 4 p (1%), 5 p (1.5%) had deep infection, 3p (1%) had mediastinitis and 26 p (7.5%) had other nonsurgical infections Eleven p (3%) died. By multivariate study underlying diseases (p<0.012) OR 4.22 (CI 1.38-12.8), inotropic support with epinephrine (p<0.027) OR 4.04 (CI 1.17-13.9) and postoperative stay longer than 12 days were found to be risk factors for infections. We concluded that presence of underlying diseases, longer hospitalization and inotropic support were risk factors for infections.

We declare no confl ict of interest. ABSTRACT Objectives:The aim of this study was to identify the clinical, radiological, and bacteriological features, risk factors, and outcome of neonates with bone and joint infections. Study design: Observational, retrospective, and analytical study of 77 patients less than 2 months of age, admitted to a tertiary neonatal intensive care unit (NICU) with the diagnosis of bone or joint infection, based on clinical, radiological, and microbiological criteria. Results: Seventy-seven patients with 99 acute osteoarthritis foci in a 16 year period were included in the study. Risk factors for infection could be identifi ed in 69% of the patients. The hip was the most frequent. Staphylococcus aureus was the main isolated microorganism. Twenty-nine infants (38%) had sequelae. Hip involvement, culture positive, and Staphylococcus aureus isolation were risk factors associated with sequelae. Conclusion: Osteoarticular infection is unusual in the neonate; however it is associated with an elevated incidence of sequelae. This mandates for a high degree of suspicion to diagnose this potentially disabling entity.

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Facebook y Twitter, ¿están ya en el consultorio de los pediatras? Encuesta sobre el uso de las redes sociales Facebook and Twitter, are they already in the pediatrician´s office? Survey on the use of social networks RESUMEN La Web 2.0 ha democratizado el uso de servicios y aplicaciones, siendo Facebook y Twitter sus principales exponentes. Se realizó una encuesta dirigida a profesionales suscriptos a las listas de discusión y visitantes al sitio web de la Sociedad Argentina de Pediatría con el objetivo de conocer el uso de la Web 2.0. Sobre 377 respuestas (76% pediatras), el 81,3% de los usuarios utilizan Facebook y el 16,5% usa Twitter. Los usuarios de Facebook en un 85% lo utilizan para fines personales, mientras que el uso profesional es del 41,2%. Los pediatras usan otras aplicaciones web 2.0 como YouTube (80,3%), compartir imágenes (52,2%) y escuchar Podcasts (34,8%). El 50% mostró interés por recibir información profesional por estos medios. Los médicos deben reconocer estas nuevas herramientas para incorporarlas a la vida profesional. La encuesta nos permitió analizar el uso de estas redes sociales por parte de los pediatras.

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