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2. Nucleoside/nucleotide reverse transcriptase inhibitor sparing regimen with once daily integrase inhibitor plus boosted darunavir is non-inferior to standard of care in virologically-suppressed children and adolescents living with HIV – Week 48 results of the randomised SMILE Penta-17-ANRS 152 clinical trial

Author

Compagnucci, A., Saidi, Y., Riault, Y., Coelho, A., Kouakam, C., Picault, L., Ndiaye, M., Meyer, L., Cagnot, C., Circosta, S., Léger, L., Simanic, S., Arulananthan, A., Gibb, D.M., Babiker, A., Chan, M., Ford, D., Hudson, F., Harper, L., Bamford, A., Nolan, A., Widuch, K., Townsend, S., Van-Looy, N., Gao, L., Little, E., Turkova, A., Fabiane, S., Calvert, J., Blackstone, J., Scott, K., Inshaw, J., Nunn, A., Nardone, A., Bilardi, D., Cressey, T.R., Chalermpantmetagul, S., Khamduang, W., Jourdain, G., Ngo Giang Huong, N., Chinwong, D., Saenjum, C., Peongjakta, R., Sukrakanchana, P., Laomanit, L., Kaewbundit, A., Khamkon, J., Than-in-at, K., Meeboon, C., Sripaoraya, W., Krueduangkam, N., Kruenual, N., Khamjakkaew, W., Klinprung, S., Giaquinto, C., Morkunaite, G., Hirt, D., Prieto Tato, L., Niehues, T., Plonné, D., Morén, C., Noguera, T., Muñoz Fernández, M.A., Bologna, R., Arazi, S., Fedullo, A.G., Taicz, M., Vicentini, E., Moragas, M., Mangano, A., Dell’Orso, M., Gatto, M., Reliquet, V., Soria, A., Paredes, E., Chereau, N., Tching Sin, M., Flet, L., Rodallec, A., Hemon, C., Elenga, N., Terrine, M.D., Blaise, N., Augustin, S., Mespoulhe, P., Pouchain, H., Pavia-Ruz, N., Muñoz- Hernández, R., Neri-Macias, A., Jarillo-Quijada, M.D., Espinosa-Sotero, C., Marques, L., Teixeira, C., Fernandes, A., Nunes, R., Nascimento, H., Tuna, J., Padrao, A., Ferraz, I., Mendes, A.C., Correira, C., Pinheiro, H., Matos, A.C., Sampaio, A.C., Oliveira, A., Caldeira, A., Tavares, M., Reis Melo, A., Castro, C., Faria, C., Prucha, C., Ribeiro, R., Monteiro, F., Candeias, M.F., Silva Milhiero, T., Gomes Neves, E., Corte-Real, R., Morgado, M., Mendes, D., Cardão, M., Violari, A., Ramsagar, N., Liberty, A., Nyati, M., Maseko, L., Khunene, M., Mkhize, S., Essack, Z., Akoojee, N., Singh, U., Fourie, Y., Govender, S., Vadee, A., Lakha, R., Erasmus, J., Mamiane, A., Daniel, T., Bhana, P., Maduna, N., Cotton, M., Groenewald, M., Slade, G., Coetzee, J., Ganger, L., Weldon, S., Wessels, M., Hoorn, L., Pieterse, S., Makola, C., Smith, K., Isaacs, M., Cweya, A., Fry, S., Barnabas, S., Theunissen, M., Nduna, N., Smuts, M., Rojo Conejo, P., Epalza, C., Fernández, M., Mellado Peña, M.J., Sainz Costa, T., Escosa García, L., Gomez Salcedo, P., Fortuny Guasch, C., Noguera Julian, T., Estepa, C., Cubells, M., Sans, E., Bruno, E., Prieto, L., Mendez García, P., Murciano Cabeza, A., Coto, M., Torrent, R., Torres Arauz, M., Navarro Gómez, M., Mur, A., Guillén Martin, S., Moreno, M., Ramos Amador, J.T., Garcia, I., Kalhert, C., Wachinger, T., Wohlwend, B., Hafner, S., Dollenmaier, G., Paioni, P., Signorell, R., Boni, J., Duppenthaler, A., Mann, B., Saegesser, C., Barbani, M., Ngampiyaskul, C., Greetanukroh, P., Khannak, P., Tearsansern, P., Chamjamrat, W., Chanto, N., Thapwai, T., Thungkham, K., Puangmalai, P., Ruklao, C., Ounchanum, P., Khusuwan, S., Denjanta, S., Thaweesombat, Y., Thewsoongnoen, J., Kaewmamueng, K., Kamboua, P., Pongprapass, S., Srisuk, W., Kongponoi, A., Limplertjareanwanich, J., Kanjanavanit, S., Saewtrakool, C., Yingyong, P., Chutima, D., Junkaew, R., Chankun, T., Srirompotong, U., Sudsaard, P., Kongsuk, K., Petpranee, T., Srirojana, S., Donngernl, D., Kamkoonmongkol, A., Na Kalasin, N., Phunkhum, P., Kekitiinwa, A.R., Amuge, P., Bbuye, D., Nalubwama, J., Namanda, S., Nsibuka Kisekka, M., Kirabira, A., Lawrence, L., Agaba, G., Ahimbisibwe, G., Nalugo, A., Namuli, F., Kadhuba, R., Namuddu, R., Nabwire, I., Kiyimba, L., Baita, A., Tikabibamu, J., Nakandi, L., Kisitu, G.P., Nabukeera Barung, N., Kityo, C.M., Musiime, V., Kaudha, E., Nanduudu, A., Mujyambere, E., Labeja Ocitti, S.P., Ategeka, J., Nambi, E., Nazzinda, R., Rutebarika, D., Basiimwa, R., Mbabazi, R., Kyobutungi, P., Nabalamba, M., Nakalyango, A., Tumusiime, J., Nakabuye, S., Mwebaza, J., Oruk, S., Namusanje, J., Musiime, A., Mugarura, L., Ojok, M., Kitabalwa, J., Katemba, C., Nannungi, M., Bagirigomwa, E., Odoch, D., Rubanga, E., Mulima, D., Babu, E.L., Baliruno, D., Inyakuwal, C., Williams, E.D., Mulindwa, A., Uyungrwoth, A., Raus, I., Mostovenko, O., Stepchenkova, T., Volokha, A., Primak, N., Kenny, J., Callaghan, A., Ahmad, M., Vergnano, S., Ross, M., Manyi, F., Nayagam, D., Hawkins, S., Ball, C., Hamlyn, E., Gilmour, C., Gilmour-White, S., Doshi, S., Fuller, E., Adebayo, A., Tupper, K., Nsirim, E., Welch, S., Daglish, J., Thrasyvoulou, L., Irvine, E., Gandhi, K., Vaughn-Gordon, Y., Sibanda, N., Compagnucci, Alexandra, Chan, Man K., Saïdi, Yacine, Cressey, Tim R., Bamford, Alasdair, Riault, Yoann, Coelho, Alexandra, Nolan, Aoife, Chalermpantmetagul, Suwalai, Morkunaite, Gabija, Amuge, Pauline, Musiime, Victor, Violari, Avy, Cotton, Mark, Kekitiinwa, Adeodata R., Kaudha, Elizabeth, Groenewald, Marisa, Liberty, Afaaf A., Kanjanavanit, Suparat, Volokha, Alla, Bologna, Rosa, Pavia Ruz, Noris, Prieto Tato, Luis, Paioni, Paolo, Marques, Laura, Reliquet, Véronique, Niehues, Tim, Welch, Steven B., Ford, Deborah, Giaquinto, Carlo, Gibb, Diana M., Babiker, Abdel, and Ramos Amador, Jose Tomas

Published
2023
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5. Staphylococcus aureus Nasal Colonization in Spanish Children. The COSACO Nationwide Surveillance Study

Author

del Rosal T, Méndez-Echevarría A, Garcia-Vera C, Escosa-Garcia L, Agud M, Chaves F, Román F, Gutierrez-Fernandez J, Ruiz de Gopegui E, Ruiz-Carrascoso G, Ruiz-Gallego MC, Bernet A, Quevedo SM, Fernández-Verdugo AM, Diez-Sebastian J, and Calvo C

Subjects
s. aureus, mrsa, child, colonization, Infectious and parasitic diseases, RC109-216
Abstract

Teresa del Rosal,1,2 Ana Méndez-Echevarría,1,2 Cesar Garcia-Vera,3 Luis Escosa-Garcia,1,2 Martin Agud,1 Fernando Chaves,4 Federico Román,5 José Gutierrez-Fernandez,6 Enrique Ruiz de Gopegui,7 Guillermo Ruiz-Carrascoso,8 Maria del Carmen Ruiz-Gallego,9 Albert Bernet,10 Sara Maria Quevedo,11 Ana Maria Fernández-Verdugo,12 Jesús Díez-Sebastian,13 Cristina Calvo1,2 On behalf of the COSACO Study Group1Pediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Madrid, Spain; 2Translational Research Network in Pediatric Infectious Diseases (RITIP), Institute for Health Research IdiPAZ, Madrid, Spain; 3“José Ramón Muñoz Fernández” Health Care Center, Aragón Health Service, Zaragoza, Spain; 4Department of Clinical Microbiology, Hospital Universitario 12 de Octubre, Madrid, Spain; 5Laboratory of Nosocomial Infections, Department of Bacteriology, CNM, Instituto de Salud Carlos III, Madrid, Spain; 6Department of Microbiology, Hospital Virgen de las Nieves, Granada, Spain; 7Department of Clinical Microbiology, Hospital Universitari Son Espases. Servicio de Microbiología, Palma de Mallorca, Spain; 8Department of Clinical Microbiology, Hospital Universitario La Paz, Madrid, Spain; 9Department of Microbiology, Hospital Universitario Virgen del Rocío, Sevilla, Spain; 10Section of Microbiology, Arnau de Vilanova University Hospital, Lleida, Spain; 11Department of Microbiology, Hospital Universitario Severo Ochoa, Leganes, Spain; 12Department of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain; 13Department of Preventive Medicine, Hospital Universitario La Paz, Madrid, SpainCorrespondence: Ana Méndez-Echevarría Pediatric Infectious and Tropical Diseases Department. Hospital La Paz-IdiPAZ, Paseo de la Castellana 261, Madrid 28046, SpainTel/Fax +34-917277479Email amendezes@yahoo.esObjective: To assess the prevalence and risk factors for S. aureus and methicillin-resistant S. aureus (MRSA) nasal colonization in Spanish children.Methods: Cross-sectional study of patients < 14 years from primary care centers all over Spain. Clinical data and nasal aspirates were collected from March to July 2018.Results: A total of 1876 patients were enrolled. Prevalence of S. aureus and MRSA colonization were 33% (95% CI 30.9– 35.1) and 1.44% (95% CI 0.9– 2), respectively. Thirty-three percent of the children (633/1876) presented chronic conditions, mainly atopic dermatitis, asthma and/or allergy (524/633). Factors associated with S. aureus colonization were age ≥ 5 years (OR 1.10, 95% CI 1.07– 1.12), male sex (OR 1.43, 95% CI 1.17– 1.76), urban setting (OR 1.46, 95% CI 1.08– 1.97) and the presence of asthma, atopic dermatitis or allergies (OR 1.25; 95% CI: 1.093– 1.43). Rural residence was the only factor associated with MRSA colonization (OR 3.62, 95% CI 1.57– 8.36). MRSA was more frequently resistant than methicillin-susceptible S. aureus to ciprofloxacin [41.2% vs 2.6%; p< 0.0001], clindamycin [26% vs 16.9%; p=0.39], and mupirocin [14.3% vs 6.7%; p=0.18]. None of the MRSA strains was resistant to tetracycline, fosfomycin, vancomycin or daptomycin.Conclusions: The main risk factors for S. aureus colonization in Spanish children are being above five years of age, male gender, atopic dermatitis, asthma or allergy, and residence in urban areas. MRSA colonization is low, but higher than in other European countries and is associated with rural settings.Keywords: S. aureus, MRSA, child, colonization

Published
2020

7. Nutritional Supplementation to Increase Influenza Vaccine Response in Children Living With HIV: A Pilot Clinical Trial

Author

Sainz T, Casas I, González-Esguevillas M, Escosa-Garcia L, Muñoz-Fernández MÁ, Prieto L, Gosalbes MJ, Jiménez-Hernández N, Ramos JT, Navarro ML, Mellado MJ, Serrano-Villar S, and Calvo C

Subjects
influenza vaccine response, children, microbiota, HIV, immunoactivation
Abstract

AIMS: Vaccine response is poor among children living with HIV. The gut microbiota has been identified as a potential target to improve vaccine immunogenicity, but data are scarce in the context of HIV infection. METHODS: Pilot, double-blind, randomized placebo-controlled trial in which 24 HIV-infected children were randomized to receive a mixture of symbiotics, omega-3/6 fatty acids, and amino acids or placebo for 4 weeks, each in combination with ART, and were then immunized against influenza. Vaccine response and safety of the nutritional supplementation were the primary outcomes. RESULTS: Eighteen HIV-infected children completed the follow-up period (mean age 11.5 ± 4.14 years, 61% female). The nutritional supplement was safe but did not enhance the response to the influenza vaccine. A 4-fold rise in antibody titers was obtained in only 37.5% of participants in the intervention arm vs. 40% in the placebo. No immunological or inflammatory predictors of vaccine response were identified. CONCLUSIONS: In this exploratory study, a 4-week course of symbiotics did not increase influenza vaccine immunogenicity in HIV-infected children. Larger studies are warranted to address the potential of modulating the microbiome in children living with HIV.

Published
2022

8. Changes from COVID-19. A perspective from internal pediatric medicine

Author

Minagorre P, Pinto E, Fernandez J, Rodriguez-Fernandez R, Ronco M, Escosa-Garcia L, Jorge J, Garcia J, and Soc Espanola Pediat Hosp SEPHO

Subjects
SARS-CoV-2, Pediatric hospitals, COVID-19, Hospital medicine, Internal pediatric medicine
Abstract

SARS-CoV-2 pandemic dimension has affected the Hospital Pediatrics Medicine assistance in our country. New challenges generated by COVID-19 require a series of proactive measures, based on existing scientific knowledge and standards of good practice, that allow the Pediatric Hospital services readiness and operability. Hospital Internal Pediatrics, as responsible of integral care of the hospitalized child, plays a leading role in the new hospital model emerging from this crisis. This review analyzes the impact of the current SARS-CoV-2 epidemic on pediatric care, and perspective of new COVID-19 outbreaks in coexistence with other viral infections. Changes secondary to pandemic involved in Hospital Pediatric units, how to prepare for future epidemics, also the involvement of pediatric units in adult care and the possible opportunities for improvement need to be revised. Assistance of patients with chronic complex conditions in epidemic circumstances, safety aspects, opportunities for teaching and ethical considerations are reviewed. The Spanish Society of Hospital Pediatrics Medicine offers with this article a series of resources for Internal Pediatric Medicine practitioners responsible to face next challenges in pediatric hospitalization units. (C) 2020 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U.

Published
2020

9. T2Candida (R) to guide antifungal and lengh of treatment of candidemia in a pediatric multivisceral transplant recipient

Author

Falces-Romero, I, Cendejas-Bueno, E, Laplaza-Gonzalez, M, Escosa-Garcia, L, Schuffelmann-Gutierrez, C, Calderon-Llopis, B, Peman, J, de la Oliva, P, and Garcia-Rodriguez, J

Subjects
Multivisceral transplant recipient, Candidemia, bacterial infections and mycoses, T2Candida
Abstract

A case of 1-year-old male multivisceral transplant recipient with candidemia diagnosed by the T2Candida (R) test is presented. Optimal management of the candidemia complemented the treatment of the global clinical episode. Duration of treatment might be established much more precisely with the T2Candida (R) test than with blood cultures.

Published
2018

10. The worldwide antibiotic resistance and prescribing in european children (ARPEC) point prevalence survey: Developing hospital-quality indicators of antibiotic prescribing for children.

Author

Soltani J., Kovacevic T., Nielsen J.P., Petersen J.R., Poorisrisak P., Jensen L.H., Laan M., Tamm E., Matsinen M., Rummukainen M.-L., Gajdos V., Olivier R., Le Marechal F., Martinot A., Prot-Labarthe S., Lorrot M., Orbach D., Pagava K., Hufnagel M., Knuf M., Schlag S.A.A., Liese J., Renner L., Enimil A., Awunyo M., Syridou G., Spyridis N., Critselis E., Kouni S., Mougkou K., Ladomenou F., Gkentzi D., Iosifidis E., Roilides E., Sahu S., Murki S., Malviya M., Kalavalapalli D.B., Singh S., Singhal T., Garg G., Garg P., Kler N., Jafarpour Z., Pouladfar G., Nicolini G., Montagnani C., Galli L., Esposito S., Vecchio A.L., Dona' D., Giaquinto C., Borgia E., D'Argenio P., De Luca M., Centenari C., Raka L., Omar A., Al-Mousa H., Mozgis D., Sviestina I., Burokiene S., Usonis V., Tavchioska G., Hargadon-Lowe A., Zarb P., Borg M.A., Gonzalez Lozano C.A., Castanon P.Z., Cancino M.E., McCullagh B., McCorry A., Gormley C., Al Maskari Z., Al-Jardani A., Pluta M., Rodrigues F., Brett A., Esteves I., Marques L., AlAjmi J.A., Cambrea S.C., Rashed A.N., Al Azmi A.A.M., Chan S.M., Isa M.S., Najdenov P., Cizman M., Unuk S., Finlayson H., Dramowski A., Mate-Cano I., Soto B., Calvo C., Santiago B., Saavedra-Lozano J., Bustinza A., Escosa-Garcia L., Ureta N., Tagarro A., Barrero P.T., Rincon-Lopez E.M., Abubakar I., Aston J., Heginbothom M., Satodia P., Garbash M., Johnson A., Sharpe D., Barton C., Menson E., Arenas-Lopez S., Luck S., Doerholt K., McMaster P., Caldwell N.A., Lunn A., Drysdale S.B., Howe R., Scorrer T., Gahleitner F., Gupta R., Nash C., Alexander J., Raman M., Bell E., Rajagopal V., Kohlhoff S., Cox E., Zaoutis T., Versporten A., Bielicki J., Drapier N., Sharland M., Goossens H., Calle G.M., Clark J., Cooper C., Blyth C.C., Francis J.R., Alsalman J., Jansens H., Mahieu L., Van Rossom P., Vandewal W., Lepage P., Blumental S., Briquet C., Robbrecht D., Maton P., Gabriels P., Rubic Z., Soltani J., Kovacevic T., Nielsen J.P., Petersen J.R., Poorisrisak P., Jensen L.H., Laan M., Tamm E., Matsinen M., Rummukainen M.-L., Gajdos V., Olivier R., Le Marechal F., Martinot A., Prot-Labarthe S., Lorrot M., Orbach D., Pagava K., Hufnagel M., Knuf M., Schlag S.A.A., Liese J., Renner L., Enimil A., Awunyo M., Syridou G., Spyridis N., Critselis E., Kouni S., Mougkou K., Ladomenou F., Gkentzi D., Iosifidis E., Roilides E., Sahu S., Murki S., Malviya M., Kalavalapalli D.B., Singh S., Singhal T., Garg G., Garg P., Kler N., Jafarpour Z., Pouladfar G., Nicolini G., Montagnani C., Galli L., Esposito S., Vecchio A.L., Dona' D., Giaquinto C., Borgia E., D'Argenio P., De Luca M., Centenari C., Raka L., Omar A., Al-Mousa H., Mozgis D., Sviestina I., Burokiene S., Usonis V., Tavchioska G., Hargadon-Lowe A., Zarb P., Borg M.A., Gonzalez Lozano C.A., Castanon P.Z., Cancino M.E., McCullagh B., McCorry A., Gormley C., Al Maskari Z., Al-Jardani A., Pluta M., Rodrigues F., Brett A., Esteves I., Marques L., AlAjmi J.A., Cambrea S.C., Rashed A.N., Al Azmi A.A.M., Chan S.M., Isa M.S., Najdenov P., Cizman M., Unuk S., Finlayson H., Dramowski A., Mate-Cano I., Soto B., Calvo C., Santiago B., Saavedra-Lozano J., Bustinza A., Escosa-Garcia L., Ureta N., Tagarro A., Barrero P.T., Rincon-Lopez E.M., Abubakar I., Aston J., Heginbothom M., Satodia P., Garbash M., Johnson A., Sharpe D., Barton C., Menson E., Arenas-Lopez S., Luck S., Doerholt K., McMaster P., Caldwell N.A., Lunn A., Drysdale S.B., Howe R., Scorrer T., Gahleitner F., Gupta R., Nash C., Alexander J., Raman M., Bell E., Rajagopal V., Kohlhoff S., Cox E., Zaoutis T., Versporten A., Bielicki J., Drapier N., Sharland M., Goossens H., Calle G.M., Clark J., Cooper C., Blyth C.C., Francis J.R., Alsalman J., Jansens H., Mahieu L., Van Rossom P., Vandewal W., Lepage P., Blumental S., Briquet C., Robbrecht D., Maton P., Gabriels P., and Rubic Z.

Abstract

Objectives: Previously, web-based tools for cross-sectional antimicrobial point prevalence surveys (PPSs) have been used in adults to develop indicators of quality improvement. We aimed to determine the feasibility of developing similar quality indicators of improved antimicrobial prescribing focusing specifically on hospitalized neonates and children worldwide. Method(s): A standardized antimicrobial PPS method was employed. Included were all inpatient children and neonates receiving an antimicrobial at 8:00 am on the day of the PPS. Denominators included the total number of inpatients. A web-based application was used for data entry, validation and reporting. We analysed 2012 data from 226 hospitals (H) in 41 countries (C) from Europe (174H; 24C), Africa (6H; 4C), Asia (25H; 8C), Australia (6H), Latin America (11H; 3C) and North America (4H). Result(s): Of 17 693 admissions, 6499 (36.7%) inpatients received at least one antimicrobial, but this varied considerably between wards and regions. Potential indicators included very high broad-spectrum antibiotic prescribing in children of mainly ceftriaxone (ranked first in Eastern Europe, 31.3%; Asia, 13.0%; Southern Europe, 9.8%), cefepime (ranked third in North America, 7.8%) and meropenem (ranked first in Latin America, 13.1%). The survey identified worryingly high use of critically important antibiotics for hospital-acquired infections in neonates (34.9%; range from 14.2% in Africa to 68.0% in Latin America) compared with children (28.3%; range from 14.5% in Africa to 48.9% in Latin America). Parenteral administration was very common among children in Asia (88%), Latin America (81%) and Europe (67%). Documentation of the reasons for antibiotic prescribing was lowest in Latin America (52%). Prolonged surgical prophylaxis rates ranged from 78% (Europe) to 84% (Latin America). Conclusion(s): Simple web-based PPS tools provide a feasible method to identify areas for improvement of antibiotic use, to set benchmarks and to

Published
2016

16. Position statement of the Spanish Society of Paediatric Infectious Diseases on the introduction, implementation and assessment of antimicrobial stewardship programmes in paediatric hospitals

Author

Goycochea-Valdivia, Walter Alfredo, Melendo Perez, Susana, Aguilera Alonso, David, Escosa-García, Luis, Baquero-Artigao, Fernando, Sociedad Española de Infectología Pediátrica (SEIP). Grupo de Trabajo PROA, Martinez Campos, Leticia, Institut Català de la Salut, [Goycochea-Valdivia WA] Servicio de Infectología, Reumatología e Inmunología Pediátrica, Hospital Universitario Virgen del Rocío, Sevilla, Spain. [Melendo Pérez S] Unitat de Patologia Infecciosa i Immunodeficiències de Pediatria, Servei de Pediatria, Vall d'Hebron Hospital Universitari, Barcelona, Spain. [Aguilera-Alonso D] Sección de Enfermedades Infecciosas, Servicio de Pediatría, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Hospital Universitario Gregorio Marañón, Madrid. CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain. [Escosa-Garcia L, Baquero-Artigao F] Servicio de Pediatría Hospitalaria, Enfermedades Infecciosas y Tropicales, Instituto de Investigación del Hospital Universitario La Paz (IdiPAZ), Madrid. CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain. [Martínez Campos L] Unidad de Infectología Pediátrica, Hospital Universitario Torrecárdenas, Almería, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
infecciones bacterianas y micosis::infección::enfermedades transmisibles [ENFERMEDADES], administración de los servicios de salud::organización y administración::administración farmacéutica::utilización de medicamentos::revisión de la utilización de medicamentos::programas de optimización del uso de los antimicrobianos [ATENCIÓN DE SALUD], Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores], acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antibacterianos [COMPUESTOS QUÍMICOS Y DROGAS], Hospitals, Pediatric, Other subheadings::Other subheadings::/drug therapy [Other subheadings], Communicable Diseases, Anti-Bacterial Agents, Antimicrobial Stewardship, Anti-Infective Agents, Management of Technology and Innovation, Health Services Administration::Organization and Administration::Pharmacy Administration::Drug Utilization::Drug Utilization Review::Antimicrobial Stewardship [HEALTH CARE], Humans, Medicaments antibacterians - Ús terapèutic, Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents [CHEMICALS AND DRUGS], Bacterial Infections and Mycoses::Infection::Communicable Diseases [DISEASES], Child, Malalties transmissibles - Tractament
Abstract

Pediatría; Resistencia antibiótica Paediatrics; Antimicrobial resistance Pediatria; Resistència antibiòtica In the past few years, antimicrobial resistance has increased, becoming a serious public health problem. The irrational use of antimicrobials is one of the main contributors to antimicrobial resistance. The paediatric population is not free from this problem, as antimicrobials are widely prescribed in this age group, often inappropriately. The introduction of antimicrobial stewardship programmes (ASPs) has proven crucial in curbing the emergence of antimicrobial resistance. At the international level, the need to develop specific paediatric ASPs has been recognised on account of the differences between adult and paediatric patients as concerns infection and approaches to diagnosis and treatment. For this reason, paediatric ASPs should be multidisciplinary programmes led by paediatric infectious disease specialists and use specific paediatric indicators (such as days of treatment, antimicrobial susceptibility patterns in the paediatric population, or clinical indicators) to help identify areas of improvement and develop effective targeted interventions. On the other hand, the support and leadership of the pertinent scientific societies are also essential. The purpose of this document is to present the position of the Sociedad Española de Infectología Pediátrica (SEIP, Spanish Society of Paediatric Infectious Diseases) concerning the implementation of paediatric ASPs in hospitals in Spain and to provide tools to facilitate their application in hospitals throughout the regional health care systems in the country. Durante los últimos años ha habido un aumento en la aparición de resistencias antimicrobianas, lo cual supone un grave problema de salud pública. El mal uso de antimicrobianos es un factor determinante en su desarrollo. La población pediátrica no queda exenta de dicha problemática ya que la prescripción de antibióticos en pediatría es elevada y en muchas ocasiones inadecuada. La incorporación de los programas de optimización de uso de antimicrobianos (PROA) ha resultado ser una medida crucial para disminuir el riesgo en la aparición de resistencias antibióticas. A nivel internacional se reconoce la necesidad de crear PROAs específicos en pediatría (PROA-P) debido a las diferencias existentes entre pacientes adultos y pediátricos en referencia a las infecciones, así como al abordaje tanto diagnóstico como terapéutico de las mismas. Por esta misma razón, los PROA-P deben ser programas multidisciplinares liderados por especialistas en infecciones pediátricas y trabajar con indicadores específicos pediátricos (DOT, patrones de sensibilidad antibiótica de población pediátrica, indicadores clínicos…) que permitan detectar puntos de mejora y establecer estrategias dirigidas eficaces. Por otro lado, es imprescindible el apoyo y liderazgo por parte de las distintas sociedades científicas implicadas. El objetivo de este documento es dar a conocer el posicionamiento de la Sociedad Española de Infectología Pediátrica (SEIP) sobre la implementación de los PROA pediátricos hospitalarios en nuestro territorio así como aportar herramientas que ayuden en la aplicación de dichos programas en los diferentes hospitales de las distintas regiones sanitarias del país.

Published
2022

17. Position statement of the Spanish Society of Paediatric Infectious Diseases on the introduction, implementation and assessment of antimicrobial stewardship programmes in paediatric hospitals.

Author

Goycochea-Valdivia WA, Melendo Pérez S, Aguilera-Alonso D, Escosa-Garcia L, Martínez Campos L, and Baquero-Artigao F

Subjects
Humans, Child, Hospitals, Pediatric, Anti-Bacterial Agents therapeutic use, Antimicrobial Stewardship, Communicable Diseases, Anti-Infective Agents therapeutic use
Abstract

In the past few years, antimicrobial resistance has increased, becoming a serious public health problem. The irrational use of antimicrobials is one of the main contributors to antimicrobial resistance. The paediatric population is not free from this problem, as antimicrobials are widely prescribed in this age group, often inappropriately. The introduction of antimicrobial stewardship programmes (ASPs) has proven crucial in curbing the emergence of antimicrobial resistance. At the international level, the need to develop specific paediatric ASPs has been recognised on account of the differences between adult and paediatric patients as concerns infection and approaches to diagnosis and treatment. For this reason, paediatric ASPs should be multidisciplinary programmes led by paediatric infectious disease specialists and use specific paediatric indicators (such as days of treatment, antimicrobial susceptibility patterns in the paediatric population, or clinical indicators) to help identify areas of improvement and develop effective targeted interventions. On the other hand, the support and leadership of the pertinent scientific societies are also essential. The purpose of this document is to present the position of the Sociedad Española de Infectología Pediátrica (SEIP, Spanish Society of Paediatric Infectious Diseases) concerning the implementation of paediatric ASPs in hospitals in Spain and to provide tools to facilitate their application in hospitals throughout the regional health care systems in the country., (Copyright © 2022 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

Published
2022
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18. Risk factors for antibiotic-resistant bacteria colonisation in children with chronic complex conditions.

Author

Agud M, de Medrano I, Mendez-Echevarria A, Sainz T, Román F, Ruiz Carrascoso G, Escosa-Garcia L, Molina Amores C, Climent FJ, Rodríguez A, Garcia-Fernandez de Villalta M, and Calvo C

Subjects
Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Carrier State epidemiology, Carrier State microbiology, Child, Chronic Disease, Cross-Sectional Studies, Gram-Negative Bacteria, Humans, Prevalence, Risk Factors, Staphylococcus aureus, Methicillin-Resistant Staphylococcus aureus, Staphylococcal Infections drug therapy, Staphylococcal Infections epidemiology, Staphylococcal Infections microbiology
Abstract

To assess drug-resistant bacterial colonisation rates and associated risk factors in children with complex chronic conditions admitted to a national reference unit in Spain. Cross-sectional study that included all children admitted to our unit from September 2018 to July 2019. Rectal swabs were obtained to determine multidrug-resistant Gram-negative bacilli (MR-GNB) colonisation, and nasal swab to determine S. aureus and methicillin-resistant S. aureus (MRSA) colonisation. Medical records were reviewed. 100 children were included, with a median of four complex chronic conditions. Sixteen percent had S. aureus colonisation, including two MRSA. S. aureus colonisation was associated with technology-dependent children, while being on antibiotic prophylaxis or having undergone antibiotic therapy in the previous month were protective factors. The prevalence of MR-GNB colonisation was 27%, which was associated with immunosuppressive therapy (aOR 31; 2.02-47]; p = 0.01), antibiotic prophylaxis (aOR 4.56; 1.4-14.86; p = 0.012), previously treated skin-infections (aOR 2.9; 1.07-8.14; p = 0.03), surgery in the previous year (aOR 1.4; 1.06-1.8; p = 0.014), and hospital admission in the previous year (aOR 1.79; [1.26-2.56]; p = 0.001). The rate of S. aureus nasal colonisation in this series was not high despite the presence of chronic conditions, and few cases corresponded to MRSA. Antibiotic prophylaxis, immunosuppressive therapies, history of infections, previous surgeries, and length of admission in the previous year were risk factors for MR-GNB colonisation., (© 2022. The Author(s).)

Published
2022
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19. Characterization of methicillin-resistant Staphylococcus aureus strains colonizing the nostrils of Spanish children.

Author

Román F, Mendez-Echevarria A, Del Rosal T, Garcia-Vera C, Escosa-Garcia L, Agud M, Chaves F, Gutiérrez-Fernández J, Ruiz de Gopegui E, Ruiz-Carrascoso G, Ruiz-Gallego MDC, Bernet A, Quevedo SM, Fernández-Verdugo AM, Sainz T, and Calvo C

Subjects
Anti-Bacterial Agents pharmacology, Bacterial Proteins metabolism, Bacterial Toxins metabolism, Child, Child, Preschool, DNA, Bacterial, Drug Resistance, Bacterial, Exfoliatins metabolism, Exotoxins metabolism, Female, Genotyping Techniques methods, Humans, Leukocidins metabolism, Male, Methicillin-Resistant Staphylococcus aureus drug effects, Microbial Sensitivity Tests, Multilocus Sequence Typing methods, Penicillin-Binding Proteins metabolism, Spain, Staphylococcal Protein A metabolism, Methicillin-Resistant Staphylococcus aureus classification, Methicillin-Resistant Staphylococcus aureus genetics, Nose microbiology, Staphylococcal Infections microbiology
Abstract

Objective: To characterize the Staphylococcus aureus strains colonizing healthy Spanish children., Methods: Between March and July 2018, 1876 Spanish children younger than 14 years attending primary healthcare centers were recruited from rural and urban areas. Staphylococcus aureus colonization of the anterior nostrils was analyzed. MecA and mecC genes, antibiotic susceptibility, and genotyping according to the spa were determined in all strains, and the following toxins were examined: Panton-Valentine leucocidin (pvl), toxic shock syndrome toxin (tst), and exfoliative toxins (eta, etb, etd). Multilocus sequence typing (MLST) and staphylococcal cassette chromosome (SCCmec) typing were performed on methicillin-resistant Staphylococcus aureus (MRSA) strains, as well as pulsed-field gel electrophoresis (PFGE)., Results: 619 strains were isolated in 1876 children (33%), and 92% of them were sent for characterization to the Spanish National Centre of Microbiology (n = 572). Twenty (3.5%) of these strains were mecA-positive. Several spa types were detected among MRSA, being t002 the most frequently observed (30%), associating with SCCmec IVc. Among MSSA, 33% were positive for tst, while only 0.73% were positive for pvl. The 20 MRSA strains were negative for pvl, and 6 (30%) harbored the tst gene., Conclusions: methicillin-resistant Staphylococcus aureus nasal colonization in Spanish children is rare, with t002 being the most observed spa type, associated with SCCmec IVc. None of the MRSA strains produced pvl, but up to 30% of S. aureus strains were positive for tst., (© 2021 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.)

Published
2021
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