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The most widely used class of antivirals available for Influenza treatment are the neuraminidase inhibitors (NAI) Oseltamivir and Zanamivir. However, amino acid (AA) substitutions in the neuraminidase may cause reduced inhibition or high antiviral resistance. In Mexico, the current state of knowledge about NAI susceptibility is scarce, in this study we report the results of 14 years of Influenza surveillance by phenotypic and genotypic methods. A total of 255 isolates were assessed with the NAI assay, including Influenza A(H1N1)pdm09, A(H3N2) and Influenza B (IBV). Furthermore, 827 sequences contained in the GISAID platform were analyzed in search of relevant mutations.Overall, five isolates showed highly reduced inhibition or reduced inhibition to Oseltamivir, and two showed reduced inhibition to Zanamivir in the NAI assays. Additionally, five A(H1N1)pdm09 sequences from the GISAID possessed AA substitutions associated to reduced inhibition to Oseltamivir and none to Zanamivir. Oseltamivir resistant A(H1N1)pdm09 harbored the H275Y mutation. No genetic mutations were identified in Influenza A(H3N2) and IBV. Overall, these results show that in Mexico the rate of NAI resistance is low (0.6%), but it is essential to continue the Influenza surveillance in order to understand the drug susceptibility of circulating strains., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: In the paediatric population, coronavirus disease (COVID-19) is usually asymptomatic or mild, but there are also severe and fatal cases., Methods: We analysed data on COVID-19 cases from the national and state-level databases of the Federal Ministry of Health of Mexico and the Department of Health of Mexico City to determine the clinical characteristics and risk factors for mortality in children. We used Cox proportional hazards regression analysis to calculate the risk of death., Results: The national and Mexico City databases had recorded a total of 18,465 (2.8%) and 5,733 (4.2%) confirmed cases of COVID-19, respectively, in individuals aged less than 18 years as of September 2020. The median age at diagnosis was 12 years (range: 0-17). The differences between cases in the national vs Mexico City databases were: 12.5% vs 8.2% of patients were hospitalised; 6% vs 3.5% had pneumonia; 2.4% vs 1.9% were admitted to the intensive care unit (ICU), and 1.3% vs 0.7% died. The independent risk factors significantly associated with a higher probability of death were pneumonia, hypertension, obesity, immunosuppression and intubation., Conclusion: In Mexico, 2.8% of all confirmed cases of COVID-19 occurred in individuals under 18 years, with a median age of 12 years and a mortality of 1.3%. The identified predictors of mortality were pneumonia, admission to the ICU, obesity, hypertension, immunosuppression, diabetes, chronic lung disease and renal disease., (Copyright © 2022. Published by Elsevier España, S.L.U.)

Background: Acute respiratory infections are the leading cause of mortality in children worldwide, especially in developing countries. Pneumonia accounts for 16% of all deaths of children under 5 years of age and was the cause of death of 935000 children in 2015. Despite its frequency and severity, information regarding its etiology is limited. The aim of this study was to identify respiratory viruses associated with community-acquired pneumonia (CAP) in children younger than 5 years old., Methods: One thousand four hundred and four children younger than 5 years of age with a clinical and/or radiological diagnosis of CAP in 11 hospitals in Mexico were included. Nasal washes were collected, placed in viral medium, and frozen at -70°C until processing. The first 832 samples were processed using the multiplex Bio-Plex/Luminex system and the remaining 572 samples using the Anyplex multiplex RT-PCR. Clinical data regarding diagnosis, clinical signs and symptoms, radiographic pattern, and risk factors were obtained and recorded., Results: Of the samples tested, 81.6% were positive for viruses. Respiratory syncytial virus (types A and B) was found in 23.7%, human enterovirus/rhinovirus in 16.6%, metapneumovirus in 5.7%, parainfluenza virus (types 1-4) in 5.5%, influenza virus (types A and B) in 3.6%, adenovirus in 2.2%, coronavirus (NL63, OC43, 229E, and HKU1) in 2.2%, and bocavirus in 0.4%. Co-infection with two or more viruses was present in 22.1%; 18.4% of the samples were negative. Using biomass for cooking, daycare attendance, absence of breastfeeding, and co-infections were found to be statistically significant risk factors for the presence of severe pneumonia., Conclusions: Respiratory syncytial virus (types A and B), human enterovirus/rhinovirus, and metapneumovirus were the respiratory viruses identified most frequently in children younger than 5 years old with CAP. Co-infection was present in an important proportion of the children., (Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.)