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3. Update on the diagnosis and treatment of tuberculosis

Author

Baquero-Artigao, Fernando, del Rosal, Teresa, Falcón-Neyra, Lola, Ferreras-Antolín, Laura, Gómez-Pastrana, David, Hernanz-Lobo, Alicia, Méndez-Echevarría, Ana, Noguera-Julian, Antoni, Pascual Sánchez, María Teresa, Rodríguez-Molino, Paula, Piñeiro-Pérez, Roi, Santiago-García, Begoña, and Soriano-Arandes, Antoni

Published
2023
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4. Actualización del diagnóstico y tratamiento de la tuberculosis

Author

Baquero-Artigao, Fernando, del Rosal, Teresa, Falcón-Neyra, Lola, Ferreras-Antolín, Laura, Gómez-Pastrana, David, Hernanz-Lobo, Alicia, Méndez-Echevarría, Ana, Noguera-Julian, Antoni, Pascual Sánchez, María Teresa, Rodríguez-Molino, Paula, Piñeiro-Pérez, Roi, Santiago-García, Begoña, and Soriano-Arandes, Antoni

Published
2023
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6. Tuberculosis disease in immunocompromised children and adolescents: a pTBnet multi-centre case-control study

Author

Rodríguez-Molino, Paula, primary, Tebruegge, Marc, additional, Noguera-Julian, Antoni, additional, Neth, Olaf, additional, Fidler, Katy, additional, Brinkmann, Folke, additional, Sainz, Talia, additional, Ivaskeviciene, Inga, additional, Ritz, Nicole, additional, Brito, Maria Joao, additional, Milheiro Silva, Tiago, additional, Chechenieva, Vira, additional, Serdiuk, Maryna, additional, Lancella, Laura, additional, Russo, Cristina, additional, Soler-García, Aleix, additional, Navarro, Maria Luisa, additional, Krueger, Renate, additional, Feiterna-Sperling, Cornelia, additional, Starshinova, Anna, additional, Hiteva, Antonina, additional, Hoffmann, Anna, additional, Kalibatas, Paulius, additional, Lo Vecchio, Andrea, additional, Scarano, Sara Maria, additional, Bustillo, Matilde, additional, Blázquez Gamero, Daniel, additional, Espiau, María, additional, Buonsenso, Danilo, additional, Falcón, Lola, additional, Turnbull, Louise, additional, Colino, Elena, additional, Rueda, Santiago, additional, Buxbaum, Charlotte, additional, Carazo, Begoña, additional, Alvarez, Cristina, additional, Dapena, Marta, additional, Piqueras, Anabel, additional, Velizarova, Svetlana, additional, Ozere, Iveta, additional, Götzinger, Florian, additional, Pareja, Marta, additional, Garrote Llanos, Maria Isabel, additional, Soto, Beatriz, additional, Rodríguez Martín, Sonia, additional, Korta, Jose Javier, additional, Pérez-Gorricho, Beatriz, additional, Herranz, Mercedes, additional, Hernández-Bartolomé, Ángel, additional, Díaz-Almirón, Mariana, additional, Kohns Vasconcelos, Malte, additional, Ferreras-Antolín, Laura, additional, and Santiago-García, Begoña, additional

Published
2024
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9. QuantiFERON-TB reversion in children and adolescents with tuberculosis.

Author

Rodríguez-Molino, Paula, González Sánchez, Araceli, Noguera-Julián, Antoni, Soler-García, Aleix, Martínez Paz, Patricia, Méndez-Echevarría, Ana, Baquero-Artigao, Fernando, González Muñoz, Miguel, Ruíz-Serrano, María Jesus, Monsonís, Manuel, Sánchez León, Rocío, Saavedra-Lozano, Jesús, Santiago-García, Begoña, and Sainz, Talía

Subjects
TUBERCULOSIS, TEENAGERS, JUVENILE diseases
Abstract

We analyzed 136 children with tuberculosis disease or infection and a positive QuantiFERON-TB (QFT) assay, followed-up for a median of 21 months (0.4-11years). QFT reversed in 16.9% of cases, with significant decreases in TB1 (-1.72 vs. -0.03 IU/ml, p=0.001) and TB2 (-1.65 vs. -0.43 IU/ml, p=0.005) levels compared to non-reverters. We found a higher QFT reversion rate among children under 5 years (25.0% vs 11.9%, p = 0.042), and those with TST induration <15mm (29% vs 13.3%, p=0.055). Our data reveal that, although QFT test remained positive in the majority of children, reversion occurred in 16% of cases in a progressive and stable pattern. Younger age and reduced TST induration were associated with QFT reversion. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Chest X-ray-Based Telemedicine Platform for Pediatric TB Diagnosis in Low Resource Settings: Development and validation (Preprint)

Author

Gómez-Valverde, Juan J, primary, Sánchez-Jacob, Ramón, additional, Ribó, José Luis, additional, Schaaf, H Simon, additional, García Delgado, Lara, additional, Hernanz-Lobo, Alicia, additional, Capellán-Martín, Daniel, additional, Lancharro, Ángel, additional, Augusto, Orvalho, additional, García-Basteiro, Alberto L, additional, Santiago-García, Begoña, additional, López-Varela, Elisa, additional, and Ledesma-Carbayo, María J, additional

Published
2023
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11. Detection of Respiratory Viruses in the Clinical Outcome of Children With Fever and Neutropenia

Author

Cerdeira Barreiro, Natalia, Santiago-García, Begoña, Casas, Inmaculada, Pozo, Francisco, Santos Sebastián, Mar, Navarro, Marisa, Mata, Cristina, Garrido-Colino, Carmen, Catalán, Pilar, Hernández-Rupérez, Belén, Huerta, Jorge, Rincón-López, Elena, Beléndez, Cristina, García-Morín, Marina, Cela, Elena, Hernández-Sampelayo, Teresa, and Saavedra-Lozano, Jesús

Published
2020
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12. Adequacy of the 10 mg/kg Daily Dose of Antituberculosis Drug Isoniazid in Infants under 6 Months of Age

Author

Instituto de Salud Carlos III, Ministerio de Sanidad y Seguridad Social (España), Ministerio de Economía y Competitividad (España), Generalitat de Catalunya, Fundació Mar, López-Ramos, Maria Goretti, Vinent, Joan, Aarnoutse, Rob, Colbers, Angela, Velasco-Arnaiz, Eneritz, Martorell, Loreto, Falcón Neyra, Lol, Neth, Olaf, Prieto Andrés, Luis, Guillén, Sara, Baquero-Artigao, Fernando, Méndez-Echevarría, Ana, Gómez-Pastrana, David, Jiménez, Ana B., Lahoz, Rebeca, Ramos Amador, José Tomás, Soriano-Arandes, Antoni, Santiago-García, Begoña, Farré, Rosa, Fortuny, Claudia, Soy, Dolors, Noguera-Julián, Antoni, Instituto de Salud Carlos III, Ministerio de Sanidad y Seguridad Social (España), Ministerio de Economía y Competitividad (España), Generalitat de Catalunya, Fundació Mar, López-Ramos, Maria Goretti, Vinent, Joan, Aarnoutse, Rob, Colbers, Angela, Velasco-Arnaiz, Eneritz, Martorell, Loreto, Falcón Neyra, Lol, Neth, Olaf, Prieto Andrés, Luis, Guillén, Sara, Baquero-Artigao, Fernando, Méndez-Echevarría, Ana, Gómez-Pastrana, David, Jiménez, Ana B., Lahoz, Rebeca, Ramos Amador, José Tomás, Soriano-Arandes, Antoni, Santiago-García, Begoña, Farré, Rosa, Fortuny, Claudia, Soy, Dolors, and Noguera-Julián, Antoni

Abstract

In 2010, the WHO recommended an increase in the daily doses of first-line anti-tuberculosis medicines in children. We aim to characterize the pharmacokinetics of the once-daily isoniazid (INH) dose at 10 mg/kg of body weight in infants <6 months of age. We performed a multicenter pharmacokinetic study in Spain. The N-acetyltransferase 2 gene was analyzed to determine the acetylation status. Samples were analyzed using a validated UPLC-UV assay. A non-compartmental pharmacokinetic analysis was performed. Twenty-three pharmacokinetic profiles were performed in 20 infants (8 females) at a median (IQR) age of 19.0 (12.6-23.3) weeks. The acetylator statuses were homozygous fast (n = 1), heterozygous intermediate (n = 12), and homozygous slow (n = 7). INH median (IQR) Cmax and AUC0-24h values were 4.8 (3.7-6.7) mg/L and 23.5 (13.4-36.7) h*mg/L and the adult targets (>3 mg/L and 11.6-26.3 h*mg/L) were not reached in three and five cases, respectively. The age at assessment or acetylator status had no impact on Cmax values, but a larger INH AUC0-24h (p = 0.025) and trends towards a longer half-life (p = 0.055) and slower clearance (p = 0.070) were observed in homozygous slow acetylators. Treatment was well tolerated; mildly elevated alanine aminotransferase levels were observed in three cases. In our series of young infants receiving isoniazid, no major safety concerns were raised, and the target adult levels were reached in most patients.

Published
2023

15. Performance of QuantiFERON-TB Gold Plus assays in paediatric tuberculosis: a multicentre PTBNET study

Author

Buonsenso, Danilo, primary, Noguera-Julian, Antoni, additional, Moroni, Rossana, additional, Hernández-Bartolomé, Angel, additional, Fritschi, Nora, additional, Lancella, Laura, additional, Cursi, Laura, additional, Soler-Garcia, Aleix, additional, Krüger, Renate, additional, Feiterna-Sperling, Cornelia, additional, Sali, Michela, additional, Lo Vecchio, Andrea, additional, Scarano, Sara, additional, Hernanz Lobo, Alicia, additional, Espiau, Maria, additional, Soriano-Arandes, Antonio, additional, Cetin, Benhur Sirvan, additional, Brinkmann, Folke, additional, Ozere, Iveta, additional, Baquero-Artigao, Fernando, additional, Tsolia, Maria, additional, Milheiro Silva, Tiago, additional, Bustillo-Alonso, Matilde, additional, Martín Nalda, Andrea, additional, Mancini, Margherita, additional, Starshinova, Anna, additional, Ritz, Nicole, additional, Velizarova, Svetlana, additional, Ferreras-Antolín, Laura, additional, Götzinger, Florian, additional, Bilogortseva, Olga, additional, Chechenyeva, Vira, additional, Tebruegge, Marc, additional, and Santiago-García, Begoña, additional

Published
2022
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16. Accuracy of Xpert Ultra for the diagnosis of paediatric tuberculosis in a low TB burden country: a prospective multicentre study

Author

Aguilera-Alonso, David, primary, Solís-García, Gonzalo, additional, Noguera-Julian, Antoni, additional, González-Martín, Julián, additional, Román Cobeña, Angely, additional, Baquero-Artigao, Fernando, additional, Toro Rueda, Carlos, additional, Rodríguez-Molino, Paula, additional, Bloise Sánchez, Iván, additional, Vallmanya, Teresa, additional, Bernet-Sánchez, Albert, additional, Minguell Domingo, Laura, additional, Rubio, Adriana, additional, Saavedra-Lozano, Jesús, additional, Ruiz-Serrano, María Jesús, additional, Blázquez-Gamero, Daniel, additional, López-Roa, Paula, additional, Gomez-Pastrana, David, additional, López Prieto, María Dolores, additional, López Medina, Eva María, additional, Gil-Brusola, Ana, additional, Martín Nalda, Andrea, additional, Soriano-Arandes, Antonio, additional, Tórtola, Teresa, additional, Falcon-Neyra, Lola, additional, González Galán, Verónica, additional, Tebruegge, Marc, additional, and Santiago-García, Begoña, additional

Published
2022
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17. SARS-CoV2 Infection During Pregnancy Causes Persistent Immune Abnormalities in Women Without Affecting the Newborns

Author

Vazquez-Alejo, Elena, primary, Tarancon-Diez, Laura, additional, Carrasco, Itzíar, additional, Vigil-Vázquez, Sara, additional, Muñoz-Chapuli, Mar, additional, Rincón-López, Elena, additional, Saavedra-Lozano, Jesús, additional, Santos-Sebastián, Mar, additional, Aguilera-Alonso, David, additional, Hernanz-Lobo, Alicia, additional, Santiago-García, Begoña, additional, de León-Luis, Juan Antonio, additional, Muñoz, Patricia, additional, Sánchez-Luna, Manuel, additional, Navarro, María Luisa, additional, and Muñoz-Fernández, Mª Ángeles, additional

Published
2022
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18. Tuberculosis treatment for children: An update

Author

Mellado Peña, María José, Santiago García, Begoña, Baquero-Artigao, Fernando, Moreno Pérez, David, Piñeiro Pérez, Roi, Méndez Echevarría, Ana, Ramos Amador, José Tomás, Gómez-Pastrana Durán, David, and Noguera Julian, Antoni

Published
2018
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20. Accuracy of Xpert Ultra for the diagnosis of paediatric tuberculosis in a low TB burden country: a prospective multicentre study

Author

Ministerio de Sanidad (España), Instituto de Salud Carlos III, European Commission, Generalitat de Catalunya, Ministerio de Ciencia e Innovación (España), Aguilera-Alonso, David, Solís-García, Gonzalo, Noguera-Julián, Antoni, González-Martín, Julián, Román Cobeña, Angely, Baquero-Artigao, Fernando, Toro Rueda, Carlos, Rodríguez-Molino, Paula, Bloise Sánchez, Iván, Vallmanya, Teresa, Bernet-Sánchez, Albert, Minguell Domingo, Laura, Rubio, Adriana, Saavedra-Lozano, Jesús, Ruiz-Serrano, María Jesús, Blázquez-Gamero, Daniel, López-Roa, Paula, Gómez-Pastrana, David, López Prieto, María Dolores, López Medina, Eva María, Gil-Brusola, Ana, Martín Nalda, Andrea, Soriano-Arandes, Antoni, Tórtola, Teresa, Falcón Neyra, Lola, González Galán, Verónica, Tebruegge, Marc, Santiago-García, Begoña, Ministerio de Sanidad (España), Instituto de Salud Carlos III, European Commission, Generalitat de Catalunya, Ministerio de Ciencia e Innovación (España), Aguilera-Alonso, David, Solís-García, Gonzalo, Noguera-Julián, Antoni, González-Martín, Julián, Román Cobeña, Angely, Baquero-Artigao, Fernando, Toro Rueda, Carlos, Rodríguez-Molino, Paula, Bloise Sánchez, Iván, Vallmanya, Teresa, Bernet-Sánchez, Albert, Minguell Domingo, Laura, Rubio, Adriana, Saavedra-Lozano, Jesús, Ruiz-Serrano, María Jesús, Blázquez-Gamero, Daniel, López-Roa, Paula, Gómez-Pastrana, David, López Prieto, María Dolores, López Medina, Eva María, Gil-Brusola, Ana, Martín Nalda, Andrea, Soriano-Arandes, Antoni, Tórtola, Teresa, Falcón Neyra, Lola, González Galán, Verónica, Tebruegge, Marc, and Santiago-García, Begoña

Abstract

[Introduction] Childhood pulmonary tuberculosis (TB) remains a diagnostic challenge. This study aimed to evaluate the performance of Xpert Ultra for the diagnosis of pulmonary TB in children in a low TB prevalence setting., [Methods] Prospective, multicentre, diagnostic accuracy study. Children with clinical or radiological suspicion of pulmonary TB were recruited at 11 paediatric units in Spain. Up to three gastric or sputum specimens were taken on 3 consecutive days, and analysed by Xpert MTB/RIF, Xpert Ultra and culture in parallel., [Results] 86 children were included (median age 4.9 years, IQR 2.0–10.0; 51.2% male). The final diagnosis was pulmonary TB in 75 patients (87.2%); 33 (44.0%) were microbiologically confirmed. A total of 219 specimens, comprising gastric aspirates (n=194; 88.6%) and sputum specimens (n=25; 11.4%), were analysed. Using culture as reference standard and comparing individual specimens, the sensitivity was 37.8% (14/37) for Xpert MTB/RIF and 81.1% (30/37) for Xpert Ultra (p<0.001); specificity was 98.4% (179/182) and 93.4% (170/182), respectively (p=0.02). In the per-patient analysis, considering positive results on any specimen, the sensitivity was 42.9% (9/21) for Xpert MTB/RIF and 81.0% for Xpert Ultra (17/21, p=0.01); specificity was 96.9% (63/65) and 87.7% (57/65, p=0.07), respectively., [Conclusions] In children with pulmonary TB in a low burden setting, Xpert Ultra has significantly higher sensitivity than the previous generation of Xpert assay and only marginally lower specificity. Therefore, in children undergoing evaluation for suspected pulmonary TB, Xpert Ultra should be used in preference to Xpert MTB/RIF whenever possible.

Published
2022

21. Treatment and outcome in children with tuberculous meningitis: A multicenter pediatric tuberculosis network european trials group study

Author

Deutsche Gesellschaft für Internationale Zusammenarbeit, National Institute for Health Research (UK), London School of Economics and Political Science, Generalitat de Catalunya, Junta de Andalucía, Thee, Stephanie [0000-0001-9090-7869], Buonsenso, Danilo [0000-0001-8567-2639], Thee, Stephanie, Basu Roy, Robindra, Blázquez-Gamero, Daniel, Falcón Neyra, Lola, Neth, Olaf, Noguera-Julián, Antoni, Lillo, Cristina, Galli, Luisa, Venturini, Elisabetta, Buonsenso, Danilo, Götzinger, Florian, Martinez-Alier, Nuria, Velizarova, Svetlana, Brinkmann, Folke, Welch, Steven B., Tsolia, Maria, Santiago-García, Begoña, Schilling, Ralph, Tebruegge, Marc, Krüger, Renate, Deutsche Gesellschaft für Internationale Zusammenarbeit, National Institute for Health Research (UK), London School of Economics and Political Science, Generalitat de Catalunya, Junta de Andalucía, Thee, Stephanie [0000-0001-9090-7869], Buonsenso, Danilo [0000-0001-8567-2639], Thee, Stephanie, Basu Roy, Robindra, Blázquez-Gamero, Daniel, Falcón Neyra, Lola, Neth, Olaf, Noguera-Julián, Antoni, Lillo, Cristina, Galli, Luisa, Venturini, Elisabetta, Buonsenso, Danilo, Götzinger, Florian, Martinez-Alier, Nuria, Velizarova, Svetlana, Brinkmann, Folke, Welch, Steven B., Tsolia, Maria, Santiago-García, Begoña, Schilling, Ralph, Tebruegge, Marc, and Krüger, Renate

Abstract

[Background]: Currently, data on treatment, outcome, and prognostic factors in children with tuberculous meningitis (TBM) in Europe are limited. To date, most existing data on TBM originate from adult studies, or studies conducted in low-resource settings., [Methods]: We designed a multicenter, retrospective study involving 27 pediatric healthcare institutions in 9 European countries via an established pediatric TB research network, before and after the 2014 revision of World Health Organization (WHO) dosing recommendations., [Results]: Of 118 children, 39 (33.1%) had TBM grade 1, 68 (57.6%) grade 2, and 11 (9.3%) grade 3. Fifty-eight (49.1%) children received a standard 4-drug treatment regimen; other commonly used drugs included streptomycin, prothionamide, and amikacin. Almost half of the patients (48.3%; 56/116) were admitted to intensive care unit, with a median stay of 10 (interquartile range [IQR] 4.5–21.0) days. Of 104 children with complete outcome data, 9.6% (10/104) died, and only 47.1% (49/104) recovered fully. Main long-term sequelae included spasticity of 1 or more limbs and developmental delay both in 19.2% (20/104), and seizure disorder in 17.3% (18/104). Multivariate regression analyses identified microbiological confirmation of TBM, the need for neurosurgical intervention, and mechanical ventilation as risk factors for unfavorable outcome., [Conclusions]: There was considerable heterogeneity in the use of TB drugs in this cohort. Despite few children presenting with advanced disease and the study being conducted in a high-resource setting, morbidity and mortality were high. Several risk factors for poor outcome were identified, which may aid prognostic predictions in children with TBM in the future.

Published
2022

22. Recommendations for the preparation and administration of antituberculosis drugs in children. Second phase of the Magistral Project of the Spanish Network for the Study of Paediatric Tuberculosis (pTBred)

Author

Piñeiro Pérez, Roi, Santiago García, Begoña, Rodríguez Marrodán, Belén, Baquero-Artigao, Fernando, Fernández-Llamazares, Cecilia M., Goretti López-Ramos, María, Vinent Genestar, Joan, Gómez-Pastrana Durán, David, and Mellado Peña, María José

Published
2016
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23. Recomendaciones para la elaboración y administración de fármacos antituberculosos en niños. Segunda fase del Proyecto Magistral de la Red Española de Estudio de la Tuberculosis Pediátrica (pTBred)

Author

Piñeiro Pérez, Roi, Santiago García, Begoña, Rodríguez Marrodán, Belén, Baquero-Artigao, Fernando, Fernández-Llamazares, Cecilia M., Goretti López-Ramos, María, Vinent Genestar, Joan, Gómez-Pastrana Durán, David, and Mellado Peña, María José

Published
2016
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24. Additional file 1 of Interleukin 6 as a marker of severe bacterial infection in children with sickle cell disease and fever: a case–control study

Author

Rincón-López, Elena María, Navarro Gómez, María Luisa, Hernández-Sampelayo Matos, Teresa, Aguilera-Alonso, David, Dueñas Moreno, Eva, Saavedra-Lozano, Jesús, Santiago García, Begoña, Santos Sebastián, María del Mar, García Morín, Marina, Beléndez Bieler, Cristina, Lorente Romero, Jorge, and Cela de Julián, Elena

Abstract

Additional file 1: Table S1. Baseline characteristics of cases and comparisons among study subgroups.

Published
2021
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25. Performance of QuantiFERON-TB Gold Plus assays in paediatric tuberculosis: a multicentre PTBNET study

Author

Buonsenso, Danilo, Noguera-Julian, Antoni, Moroni, Rossana, Hernández-Bartolomé, Angel, Fritschi, Nora, Lancella, Laura, Cursi, Laura, Soler-Garcia, Aleix, Kru¨ger, Renate, Feiterna-Sperling, Cornelia, Sali, Michela, Lo Vecchio, Andrea, Scarano, Sara, Hernanz Lobo, Alicia, Espiau, Maria, Soriano-Arandes, Antonio, Cetin, Benhur Sirvan, Brinkmann, Folke, Ozere, Iveta, Baquero-Artigao, Fernando, Tsolia, Maria, Milheiro Silva, Tiago, Bustillo-Alonso, Matilde, Martín Nalda, Andrea, Mancini, Margherita, Starshinova, Anna, Ritz, Nicole, Velizarova, Svetlana, Ferreras-Antolín, Laura, Go¨tzinger, Florian, Bilogortseva, Olga, Chechenyeva, Vira, Tebruegge, Marc, and Santiago-García, Begoña

Abstract

RationaleIn 2016, a new interferon-gamma release assay (IGRA) was introduced, QuantiFERON-TB Gold Plus (QFT-Plus), claimed to have improved sensitivity in active tuberculosis (TB).ObjectivesThis study aimed to determine the performance of QFT-Plus, compared with previous generation IGRAs and the tuberculin skin test (TST), in children with TB in Europe.MethodsMulticentre, ambispective cohort study within the Paediatric Tuberculosis Network European Trials Group (ptbnet), a dedicated paediatric TB research network comprising >300 members, capturing TB cases <18 years-of-age diagnosed between January 2009 and December 2019.Measurements and main results1001 TB cases from 16 countries were included (mean age (IQR) 5.6 (2.4–12.1) years). QFT-Plus was performed in 358, QFT Gold in-Tube (QFT-GIT) in 600, T-SPOT.TBin 58 and TST in 636 cases. The overall test sensitivities were: QFT-Plus 83.8% (95% CI 80.2% to 87.8%), QFT-GIT 85.5% (95% CI 82.7% to 88.3%), T-SPOT.TB77.6% (95% CI 66.9% to 88.3%) and TST (cut-off ≥10 mm) 83.3% (95% CI 83.3% to 86.2%). There was a trend for tests to have lower sensitivity in patients with miliary and/or central nervous system (CNS) TB (73.1%, 70.9%, 63.6% and 43.5%, respectively), and in immunocompromised patients (75.0%, 59.6%, 45.5% and 59.1%, respectively).ConclusionsThe results indicate that the latest generation IGRA assay, QFT-Plus, does not perform better than previous generation IGRAs or the TST in children with TB disease. Overall, tests performed worse in CNS and miliary TB, and in immunocompromised children. None of the tests evaluated had sufficiently high sensitivity to be used as a rule-out test in children with suspected TB.

Published
2023
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26. COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study.

Author

Götzinger, Florian, Santiago-García, Begoña, Lanaspa, Miguel, Lancella, Laura, Calò Carducci, Francesca FI, Gabrovska, Natalia, Velizarova, Svetlana, Prunk, Petra, Osterman, Veronika, Krivec, Uros, Lo Vecchio, Andrea, Shingadia, Delane, Soriano-Arandes, Antoni, Melendo, Susana, Lanari, Marcello, Pierantoni, Luca, Wagner, Noemie, L'Huillier, Arnaud AG, Heininger, Ulrich, Ritz, Nicole, Bandi, Srini, Krajcar, Nina, Roglić, Srđan, Christiaens, Christelle, Creuven, Marine, Buonsenso, Danilo, Bogyi, Matthias, Brinkmann, Folke, Tebruegge, Marc, ptbnet COVID-19 Study Group, Götzinger, Florian, Santiago-García, Begoña, Lanaspa, Miguel, Lancella, Laura, Calò Carducci, Francesca FI, Gabrovska, Natalia, Velizarova, Svetlana, Prunk, Petra, Osterman, Veronika, Krivec, Uros, Lo Vecchio, Andrea, Shingadia, Delane, Soriano-Arandes, Antoni, Melendo, Susana, Lanari, Marcello, Pierantoni, Luca, Wagner, Noemie, L'Huillier, Arnaud AG, Heininger, Ulrich, Ritz, Nicole, Bandi, Srini, Krajcar, Nina, Roglić, Srđan, Christiaens, Christelle, Creuven, Marine, Buonsenso, Danilo, Bogyi, Matthias, Brinkmann, Folke, Tebruegge, Marc, and ptbnet COVID-19 Study Group

Abstract

To date, few data on paediatric COVID-19 have been published, and most reports originate from China. This study aimed to capture key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic., DecretOANoAutActif, info:eu-repo/semantics/published

Published
2020

27. Tuberculosis in a Spanish cohort of children living with HIV: the CHOTIS study (Childhood HIV & TB study)

Author

Cohorte Nacional de Pacientes Pediátricos con Infección VIH (España), Red Española de Investigación en SIDA, Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo (España), European Commission, López-Medina, E. M., Sainz, Talia, Jiménez de Ory, Santiago, Mellado, Maria Jose, Gonzalez-Tome, Maria I., Colino, Elena, Vallmanya, Teresa, Falcón Neyra, Lola, Frick, M. Antoinette, Martínez-Pérez, Julia, Andrés Andrés, A. G., Bustillo Alonso, Matilde, Guerrero Laleona, C., Méndez Hernández, M., Collado, Pilar, Ramos Amador, José Tomás, Navarro Gómez, María Luisa, Santiago-García, Begoña, Cohorte Nacional de Pacientes Pediátricos con Infección VIH (España), Red Española de Investigación en SIDA, Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo (España), European Commission, López-Medina, E. M., Sainz, Talia, Jiménez de Ory, Santiago, Mellado, Maria Jose, Gonzalez-Tome, Maria I., Colino, Elena, Vallmanya, Teresa, Falcón Neyra, Lola, Frick, M. Antoinette, Martínez-Pérez, Julia, Andrés Andrés, A. G., Bustillo Alonso, Matilde, Guerrero Laleona, C., Méndez Hernández, M., Collado, Pilar, Ramos Amador, José Tomás, Navarro Gómez, María Luisa, and Santiago-García, Begoña

Abstract

[Background] Tuberculosis (TB) is the leading opportunistic infection in children with human immunodeficiency virus (HIV), but is uncommon in low prevalence regions. We aim to describe the changing epidemiology and clinical presentation of TB-HIV co-infection in a cohort of HIV-infected children in Spain., [Methods] Children diagnosed with TB between 1995 and 2016 in the paediatric HIV cohort were identified. The incidence and clinical presentation were compared in three periods: 1995–1999 (P1, before initiation of combined antiretroviral therapy, cART), 2000–2009 (P2, increase in immigration), and 2010–2016 (P3, decrease in immigration)., [Results] We included 29 TB cases among 1183 children aged <18 years (2.4%, 243/100 000 person-years). The proportion was stable in P1 and P2 (1.3%), but decreased in P3 (0.8%). The median age at TB diagnosis was 6.4 years (IQR 4–10.6); most children in P3 were aged >10 years (20% vs. 23.1% vs. 83.3%, P = 0.01). TB was diagnosed at HIV presentation in 11/29 children (37.9%). Foreign-born children accounted for respectively 0%, 8% and 67% of the total number of children in each period (P ≤ 0.0001). One third had extrapulmonary TB; four children died (13.8%)., [Conclusion] In our cohort, the incidence of TB-HIV co-infection decreased with decline in immigration. In regions with adequate cART coverage and low TB transmission, paediatric TB-HIV coinfection is uncommon, but associated with significant morbidity. Strategies for TB surveillance, diagnosis and treatment in this vulnerable population should be reinforced.

Published
2020

29. Risk-score based strategy to minimize antibiotic exposure in children with sickle cell disease and fever.

Author

Rincón-López, Elena María, Navarro Gómez, María Luisa, Hernández-Sampelayo Matos, Teresa, Aguilera-Alonso, David, Dueñas Moreno, Eva, Bellón Cano, José María, Saavedra-Lozano, Jesús, del Mar Santos Sebastián, María, García Morín, Marina, Beléndez Bieler, Cristina, Lorente Romero, Jorge, Cela de Julián, Elena, on behalf of F-DREP Study Group, Santiago García, Begoña, Hernanz Lobo, Alicia, Bardón Cancho, Eduardo, Garrido Colino, Carmen, Huerta Aragonés, Jorge, Mata Fernández, Cristina, and Míguez Navarro, Concepción

Subjects
BACTERIAL disease risk factors, ANTIMICROBIAL stewardship, C-reactive protein, ANTI-infective agents, RISK assessment, SICKLE cell anemia, FEVER in children, LONGITUDINAL method, HYPOXEMIA
Abstract

Severe bacterial infections (SBI) have become less frequent in children with sickle cell disease (SCD) in the last decades. However, because of their potential risk of SBI, they usually receive empirical therapy with broad-spectrum antibiotics when they develop fever and are hospitalized in many cases. We performed a prospective study including 79 SCD patients with fever [median age 4.1 (1.7–7.5) years, 78.5% males; 17 of the episodes were diagnosed with SBI and 4 of them were confirmed] and developed a risk score for the prediction of SBI. The optimal score included CRP > 3 mg/dl, IL-6 > 125 pg/ml and hypoxemia, with an AUC of 0.91 (0.83–0.96) for the prediction of confirmed SBI and 0.86 (0.77–0.93) for possible SBI. We classified the patients in 3 groups: low, intermediate and high risk of SBI. Our risk-score-based management proposal could help to safely minimize antibiotic treatments and hospital admissions in children with SCD at low risk of SBI. [ABSTRACT FROM AUTHOR]

Published
2022
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30. COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study

Author

Götzinger, Florian, primary, Santiago-García, Begoña, additional, Noguera-Julián, Antoni, additional, Lanaspa, Miguel, additional, Lancella, Laura, additional, Calò Carducci, Francesca I, additional, Gabrovska, Natalia, additional, Velizarova, Svetlana, additional, Prunk, Petra, additional, Osterman, Veronika, additional, Krivec, Uros, additional, Lo Vecchio, Andrea, additional, Shingadia, Delane, additional, Soriano-Arandes, Antoni, additional, Melendo, Susana, additional, Lanari, Marcello, additional, Pierantoni, Luca, additional, Wagner, Noémie, additional, L'Huillier, Arnaud G, additional, Heininger, Ulrich, additional, Ritz, Nicole, additional, Bandi, Srini, additional, Krajcar, Nina, additional, Roglić, Srđan, additional, Santos, Mar, additional, Christiaens, Christelle, additional, Creuven, Marine, additional, Buonsenso, Danilo, additional, Welch, Steven B, additional, Bogyi, Matthias, additional, Brinkmann, Folke, additional, Tebruegge, Marc, additional, Pfefferle, Jasmin, additional, Zacharasiewicz, Angela, additional, Berger, Angelika, additional, Berger, Roland, additional, Strenger, Volker, additional, Kohlfürst, Daniela S., additional, Zschocke, Anna, additional, Bernar, Benoît, additional, Simma, Burkhard, additional, Haberlandt, Edda, additional, Thir, Christina, additional, Biebl, Ariane, additional, Vanden Driessche, Koen, additional, Boiy, Tine, additional, Van Brusselen, Daan, additional, Bael, An, additional, Debulpaep, Sara, additional, Schelstraete, Petra, additional, Pavic, Ivan, additional, Nygaard, Ulrikka, additional, Glenthoej, Jonathan P., additional, Heilmann Jensen, Lise, additional, Lind, Ilona, additional, Tistsenko, Mihhail, additional, Uustalu, Ülle, additional, Buchtala, Laura, additional, Thee, Stephanie, additional, Kobbe, Robin, additional, Rau, Cornelius, additional, Schwerk, Nicolaus, additional, Barker, Michael, additional, Tsolia, Maria, additional, Eleftheriou, Irini, additional, Gavin, Patrick, additional, Kozdoba, Oksana, additional, Zsigmond, Borbàla, additional, Valentini, Piero, additional, Ivaškeviciene, Inga, additional, Ivaškevicius, Rimvydas, additional, Vilc, Valentina, additional, Schölvinck, Elisabeth, additional, Rojahn, Astrid, additional, Smyrnaios, Anastasios, additional, Klingenberg, Claus, additional, Carvalho, Isabel, additional, Ribeiro, Andreia, additional, Starshinova, Anna, additional, Solovic, Ivan, additional, Falcón, Lola, additional, Neth, Olaf, additional, Minguell, Laura, additional, Bustillo, Matilde, additional, Gutiérrez-Sánchez, Aida M., additional, Guarch Ibáñez, Borja, additional, Ripoll, Francesc, additional, Soto, Beatriz, additional, Kötz, Karsten, additional, Zimmermann, Petra, additional, Schmid, Hanna, additional, Zucol, Franziska, additional, Niederer, Anita, additional, Buettcher, Michael, additional, Cetin, Benhur S., additional, Bilogortseva, Olga, additional, Chechenyeva, Vera, additional, Demirjian, Alicia, additional, Shackley, Fiona, additional, McFetridge, Lynne, additional, Speirs, Lynne, additional, Doherty, Conor, additional, Jones, Laura, additional, McMaster, Paddy, additional, Murray, Clare, additional, Child, Frances, additional, Beuvink, Yvonne, additional, Makwana, Nick, additional, Whittaker, Elisabeth, additional, Williams, Amanda, additional, Fidler, Katy, additional, Bernatoniene, Jolanta, additional, Song, Rinn, additional, Oliver, Zoe, additional, and Riordan, Andrew, additional

Published
2020
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31. Effect of an intervention to improve the prescription of antifungals in pediatric hematology-oncology.

Author

Santiago‐García, Begoña, Rincón‐López, Elena María, Ponce Salas, Beatriz, Aguilar de la Red, Yurena, Garrido Colino, Carmen, Martínez Fernández‐Llamazares, Cecilia, Saavedra‐Lozano, Jesús, Hernández‐Sampelayo Matos, Teresa, Santiago-García, Begoña, Rincón-López, Elena María, Martínez Fernández-Llamazares, Cecilia, Saavedra-Lozano, Jesús, Hernández-Sampelayo Matos, Teresa, and POPA Study Group

Published
2020
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33. Interleukin 6 as a marker of severe bacterial infection in children with sickle cell disease and fever: a case-control study.

Author

Rincón-López, Elena María, Navarro Gómez, María Luisa, Hernández-Sampelayo Matos, Teresa, Aguilera-Alonso, David, Dueñas Moreno, Eva, Saavedra-Lozano, Jesús, Santiago García, Begoña, Santos Sebastián, María del Mar, García Morín, Marina, Beléndez Bieler, Cristina, Lorente Romero, Jorge, Cela de Julián, Elena, F-DREP Study Group, Hernanz Lobo, Alicia, Garrido Colino, Carmen, Huerta Aragonés, Jorge, Mata Fernández, Cristina, Bardón Cancho, Eduardo, Míguez Navarro, Concepción, and Mora Capín, Andrea

Subjects
SICKLE cell anemia, BACTERIAL diseases, CASE-control method, DIAGNOSIS, FEVER, DIAGNOSIS of bacterial diseases, INTERLEUKINS, RESEARCH funding, LONGITUDINAL method, DISEASE complications
Abstract

Background: Etiological diagnosis of fever in children with sickle cell disease (SCD) is often challenging. The aim of this study was to analyze the pattern of inflammatory biomarkers in SCD febrile children and controls, in order to determine predictors of severe bacterial infection (SBI).Methods: A prospective, case-control study was carried out during 3 years, including patients younger than 18 years with SCD and fever (cases) and asymptomatic steady-state SCD children (controls). Clinical characteristics and laboratory parameters, including 10 serum proinflammatory cytokines (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-17a, IFN-γ and TNF-α) and comparisons among study subgroups were analyzed.Results: A total of 137 patients (79 cases and 58 controls) were included in the study; 78.5% males, median age 4.1 (1.7-7.5) years. Four cases were diagnosed with SBI, 41 viral infection (VI), 33 no proven infection (NPI) and 1 bacterial-viral coinfection (the latter excluded from the subanalyses). IL-6 was significantly higher in patients with SBI than in patients with VI or NPI (163 vs 0.7 vs 0.7 pg/ml, p < 0.001), and undetectable in all controls. The rest of the cytokines analyzed did not show any significant difference. The optimal cut-off value of IL-6 for the diagnosis of SBI was 125 pg/mL, with high PPV and NPV (PPV of 100% for a prevalence rate of 5, 10 and 15% and NPV of 98.7%, 97.3% and 95.8% for those prevalences rates, respectively).Conclusion: We found that IL-6 (with a cut-off value of 125 pg/ml) was an optimal marker for SBI in this cohort of febrile SCD children, with high PPV and NPV. Therefore, given its rapid elevation, IL-6 may be useful to early discriminate SCD children at risk of SBI, in order to guide their management. [ABSTRACT FROM AUTHOR]

Published
2021
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34. Enfermedad meningocócica invasiva en niños y adultos en un hospital terciario: epidemiología reciente y factores pronósticos

Author

Maturana Martínez, Daniela, primary, Aguilera-Alonso, David, additional, García Mancebo, Julia, additional, Navarro, María Luisa, additional, Hernández Sampelayo, Teresa, additional, Rincón López, Elena María, additional, Santiago-García, Begoña, additional, Saavedra-Lozano, Jesús, additional, Santos, Mar, additional, and Cercenado, Emilia, additional

Published
2019
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38. Perfil epidemiológico y clínico de la tuberculosis en niños de la Comunidad Autónoma de Madrid

Author

Ruiz Contreras, Jesús, Mellado Peña, María José, Santiago García, Begoña, Ruiz Contreras, Jesús, Mellado Peña, María José, and Santiago García, Begoña

Abstract

La tuberculosis (TB) es una de las enfermedades más antiguas de las que se tiene constancia. El término tuberculosis fue empleado por primera vez por JL Schönlein en 1839, basándose en la palabra tubérculo, que previamente había sido designada por R Morton en 1689 para referirse a las lesiones características de la enfermedad. Su agente causal, la bacteria Mycobacterium tuberculosis (MTB) fue descrita por R Koch en 1882. Esta bacteria pertenece al complejo M. tuberculosis complex, junto con M. bovis, M. africanum, M. canetti y M. microti. Estas especies son también responsables de la TB humana, pero tienen menor relevancia desde el punto de vista clínico y sanitario. MTB es un bacilo ácido-alcohol resistente, inmóvil y no esporulado, que mide de 0,8 a 4 micras. Tiene un metabolismo aeróbico estricto, con desarrollo óptimo a 35-37ºC, y su crecimiento depende del oxígeno y del pH circulante. Es muy resistente a las condiciones de frío, congelación y desecación. Por el contrario, es muy sensible al calor, la luz solar y la luz ultravioleta. Su multiplicación es muy lenta, dividiéndose cada 16-20 horas, y tarda de 3 a 6 semanas para crecer en medios selectivos. Este lento crecimiento justifica su clínica inespecífica y lenta instauración. Ante circunstancias adversas, puede entrar en estado de latencia, y permanecer en esas condiciones durante años. MTB posee una pared celular rica en lípidos de alto peso molecular, responsable de varias de sus características biológicas, como la dificultad para ser destruido por los macrófagos o la resistencia a la desecación...

Published
2017

41. Diagnostic potential of combining plasma biomarkers of tissue damage and inflammation in pediatric TB

Author

López-Suárez, Andrea, Santos-Sebastián, Mar, Hernanz-Lobo, Alicia, Rincón-López, Elena, Aguilera-Alonso, David, Saavedra-Lozano, Jesús, Ruiz Serrano, María Jesús, Hernández-Bartolomé, Ángel, Medrano de Dios, Luz María, Jiménez Fuentes, José Luis, Navarro, María Luisa, Tebruegge, Marc, and Santiago-García, Begoña

Abstract

Immune-based diagnostic tests for tuberculosis (TB) have suboptimal sensitivity in children and cannot differentiate between latent infection (LTBI) and active disease. This study evaluated the diagnostic potential of a broad range of biomarkers of tissue damage and inflammation in unstimulated plasma in children.

Published
2024
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42. Recomendaciones para la elaboración y administración de fármacos antituberculosos en niños. Segunda fase del Proyecto Magistral de la Red Española de Estudio de la Tuberculosis Pediátrica (pTBred)

Author

Piñeiro Pérez, Roi, Santiago García, Begoña, Rodríguez Marrodán, Belén, Baquero-Artigao, Fernando, Fernández-Llamazares, Cecilia M., Goretti López-Ramos, María, Vinent Genestar, Joan, Gómez-Pastrana Durán, David, and Mellado Peña, María José

Abstract

La Red Española de Estudio de la Tuberculosis Pediátrica ha evidenciado una falta de consenso nacional en la administración de antituberculosos en niños, propiciada por la escasez de presentaciones pediátricas específicas. Es prioritario homogeneizar el tratamiento de la tuberculosis en niños en nuestro país. Un grupo de expertos españoles en tuberculosis infantil y en el área de medicamentos pediátricos proponen una actuación conjunta, con la finalidad de mejorar esta situación en nuestro medio. Para ello se constituye un Grupo de Trabajo, liderado por pTBred, en el que participan otras 5 sociedades e instituciones científicas. Se proponen las siguientes fórmulas magistrales en forma de suspensión o solución oral para el tratamiento de la tuberculosis en niños: isoniacida 50mg/ml, pirazinamida 100mg/ml y etambutol 50mg/ml. Se especifican materias primas, periodo de validez y condiciones de conservación y administración. Se establecen recomendaciones para el uso de fármacos combinados a dosis fijas. Si no se consigue la dosis apropiada mediante fármacos combinados a dosis fijas, y no se dispone de fórmula magistral, se recomienda la administración mediante comprimidos triturados. El adecuado cumplimiento terapéutico y la administración de dosis óptimas de los fármacos antituberculosos constituyen pilares fundamentales en el control y erradicación de la enfermedad. La oportunidad de disponer de este documento multidisciplinar en España favorecerá el correcto tratamiento de la tuberculosis pediátrica, y será una guía útil para todos los pediatras y farmacéuticos que lo precisen.

Published
2024
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43. Actualización del diagnóstico y tratamiento de la tuberculosis

Author

Baquero-Artigao, Fernando, del Rosal, Teresa, Falcón-Neyra, Lola, Ferreras-Antolín, Laura, Gómez-Pastrana, David, Hernanz-Lobo, Alicia, Méndez-Echevarría, Ana, Noguera-Julian, Antoni, Pascual Sánchez, María Teresa, Rodríguez-Molino, Paula, Piñeiro-Pérez, Roi, Santiago-García, Begoña, and Soriano-Arandes, Antoni

Abstract

Más de un millón de pacientes menores de 15 años desarrollan tuberculosis (TB) anualmente en el mundo, según estimaciones de la OMS. La TB por cepas resistentes a los fármacos de primera línea alcanza al 25% de los nuevos casos en algunas regiones. Aunque España es considerada un país de baja incidencia, varios centenares de niños y adolescentes enferman de TB cada año. La importancia de la TB pediátrica ha sido minimizada durante años por la dificultad en confirmar el diagnóstico microbiológico y la escasa contagiosidad que asocia. Sin embargo, en los últimos 15 años, se han reportado mejoras relevantes en los informes epidemiológicos de la TB en niños y adolescentes, han surgido nuevos test inmunodiagnósticos, se dispone de estudios de biología molecular que permiten un diagnóstico microbiológico y una identificación de mutaciones asociadas a resistencia rápidos, han surgido nuevos fármacos antituberculosos de segunda línea, también en pediatría, y se han publicado ensayos clínicos que validan tratamientos acortados en algunos pacientes. Este documento, realizado por un grupo de expertos de la Sociedad Española de Infectología Pediátrica y la Sociedad Española de Neumología Pediátrica, actualiza y complementa las recomendaciones previas para el manejo diagnóstico y terapéutico del niño con TB en España, en base a las nuevas evidencias científicas disponibles.

Published
2024
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44. Perfil epidemiológico y clínico de la tuberculosis en niños de la Comunidad Autónoma de Madrid

Author

Santiago García, Begoña, Ruiz Contreras, Jesús, Mellado Peña, María José, Santiago García, Begoña, Ruiz Contreras, Jesús, and Mellado Peña, María José

Abstract

La tuberculosis (TB) es una de las enfermedades más antiguas de las que se tiene constancia. El término tuberculosis fue empleado por primera vez por JL Schönlein en 1839, basándose en la palabra tubérculo, que previamente había sido designada por R Morton en 1689 para referirse a las lesiones características de la enfermedad. Su agente causal, la bacteria Mycobacterium tuberculosis (MTB) fue descrita por R Koch en 1882. Esta bacteria pertenece al complejo M. tuberculosis complex, junto con M. bovis, M. africanum, M. canetti y M. microti. Estas especies son también responsables de la TB humana, pero tienen menor relevancia desde el punto de vista clínico y sanitario. MTB es un bacilo ácido-alcohol resistente, inmóvil y no esporulado, que mide de 0,8 a 4 micras. Tiene un metabolismo aeróbico estricto, con desarrollo óptimo a 35-37ºC, y su crecimiento depende del oxígeno y del pH circulante. Es muy resistente a las condiciones de frío, congelación y desecación. Por el contrario, es muy sensible al calor, la luz solar y la luz ultravioleta. Su multiplicación es muy lenta, dividiéndose cada 16-20 horas, y tarda de 3 a 6 semanas para crecer en medios selectivos. Este lento crecimiento justifica su clínica inespecífica y lenta instauración. Ante circunstancias adversas, puede entrar en estado de latencia, y permanecer en esas condiciones durante años. MTB posee una pared celular rica en lípidos de alto peso molecular, responsable de varias de sus características biológicas, como la dificultad para ser destruido por los macrófagos o la resistencia a la desecación...

Published
2016

45. Pediatric Extrapulmonary Tuberculosis

Author

Santiago-García, Begoña, primary, Blázquez-Gamero, Daniel, additional, Baquero-Artigao, Fernando, additional, Ruíz-Contreras, Jesús, additional, Bellón, Jose M., additional, Muñoz-Fernández, Maria A., additional, and Mellado-Peña, María J., additional

Published
2016
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46. Comparison of Mycobacterium lentiflavum and Mycobacterium avium-intracellulare Complex Lymphadenitis

Author

Jiménez-Montero, Beatriz, primary, Baquero-Artigao, Fernando, additional, Saavedra-Lozano, Jesús, additional, Tagarro-García, Alfredo, additional, Blázquez-Gamero, Daniel, additional, Cilleruelo-Ortega, María J., additional, Ramos-Amador, José T., additional, Galé-Ansó, Inés, additional, Marín, Natalia, additional, Gómez-García, Raquel, additional, Santiago-García, Begoña, additional, Garrido, Jesus, additional, and López, Goosen, additional

Published
2014
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47. Practical approach to screen vesicoureteral reflux after a first urinary tract infection.

Author

Álvarez Fuente, María, Sainz Costa, Talía, Santiago García, Begoña, Algar Serrano, Marcelina, Sosa Alonso, Manuel, and Aleo Luján, Esther

Subjects
URINARY tract infection diagnosis, COMPUTED tomography, MEDICAL screening, PEDIATRICS, SERIAL publications, ULTRASONIC imaging, URINATION, UROLOGY, DATA analysis, VESICO-ureteral reflux, DIAGNOSIS
Abstract

Introduction: Vesicoureteral reflux (VUR) is a common pediatric urologic disorder. After the first urinary tract infection (UTI), imaging studies are recommended, starting with a renal ultrasound (RUS). Voiding cystourethrography (VCUG) and dimercaptosuccinic acid (DMSA) scan are the other main radiologic studies used to detect VUR. We evaluated the use of RUS as a screening method for VUR in children below 2 years of age, in order to avoid unnecessary VCUG. Materials and Methods: Medical records and imaging studies of infants (<2 years) who had their first UTI in a 6 year period were retrospectively reviewed. We evaluated the sensitivity, specificity, and negative predictive values of RUS and DMSA for diagnosing VUR. Results: Among 155 children (51% males) with their first UTI, 148 RUS were performed, 128 VCUG and 29 DMSA. VUR was detected in 21% patients; 14.5% low grade and 6.5% high grade. One hundred and twenty-one patients underwent both RUS and VCUG, 101 RUS were normal and 20 abnormal. Of the normal RUS 98% had no or low grade VUR. Among those with an abnormality on RUS 30% had high grade VUR (P < 0.001). Conclusions: After the first UTI in infants (<2 years) RUS is a good screening method for VUR. Among such shildren with a normal RUS, we do not recommend VCUG or DMSA. In our opinion, VCUG should be performed only in patients with abnormal findings in RUS or in recurrent UTI. [ABSTRACT FROM AUTHOR]

Published
2014
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48. Comparison of Mycobacterium lentiflavumand Mycobacterium avium-intracellulareComplex Lymphadenitis

Author

Jiménez-Montero, Beatriz, Baquero-Artigao, Fernando, Saavedra-Lozano, Jesús, Tagarro-García, Alfredo, Blázquez-Gamero, Daniel, Cilleruelo-Ortega, María J., Ramos-Amador, José T., Galé-Ansó, Inés, Marín, Natalia, Gómez-García, Raquel, Santiago-García, Begoña, Garrido, Jesus, and López, Goosen

Abstract

Mycobacterium lentiflavumis considered a rare pathogen causing nontuberculous mycobacterial (NTM) lymphadenitis.

Published
2014
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49. Perfil epidemiológico y clínico de la tuberculosis en niños de la Comunidad Autónoma de Madrid

Author

Santiago García, Begoña, Ruiz Contreras, Jesús, and Mellado Peña, María José

Subjects
Pediatría, Enfermedades infecciosas, Neumología
Abstract

La tuberculosis (TB) es una de las enfermedades más antiguas de las que se tiene constancia. El término tuberculosis fue empleado por primera vez por JL Schönlein en 1839, basándose en la palabra tubérculo, que previamente había sido designada por R Morton en 1689 para referirse a las lesiones características de la enfermedad. Su agente causal, la bacteria Mycobacterium tuberculosis (MTB) fue descrita por R Koch en 1882. Esta bacteria pertenece al complejo M. tuberculosis complex, junto con M. bovis, M. africanum, M. canetti y M. microti. Estas especies son también responsables de la TB humana, pero tienen menor relevancia desde el punto de vista clínico y sanitario. MTB es un bacilo ácido-alcohol resistente, inmóvil y no esporulado, que mide de 0,8 a 4 micras. Tiene un metabolismo aeróbico estricto, con desarrollo óptimo a 35-37ºC, y su crecimiento depende del oxígeno y del pH circulante. Es muy resistente a las condiciones de frío, congelación y desecación. Por el contrario, es muy sensible al calor, la luz solar y la luz ultravioleta. Su multiplicación es muy lenta, dividiéndose cada 16-20 horas, y tarda de 3 a 6 semanas para crecer en medios selectivos. Este lento crecimiento justifica su clínica inespecífica y lenta instauración. Ante circunstancias adversas, puede entrar en estado de latencia, y permanecer en esas condiciones durante años. MTB posee una pared celular rica en lípidos de alto peso molecular, responsable de varias de sus características biológicas, como la dificultad para ser destruido por los macrófagos o la resistencia a la desecación...

50. Performance of QuantiFERON-TB Gold Plus assays in paediatric tuberculosis: a multicentre PTBNET study

Author

Danilo, Buonsenso, Antoni, Noguera-Julian, Rossana, Moroni, Angel, Hernández-Bartolomé, Nora, Fritschi, Laura, Lancella, Laura, Cursi, Aleix, Soler-Garcia, Renate, Krüger, Cornelia, Feiterna-Sperling, Michela, Sali, Andrea, Lo Vecchio, Sara, Scarano, Alicia, Hernanz Lobo, Maria, Espiau, Antonio, Soriano-Arandes, Benhur Sirvan, Cetin, Folke, Brinkmann, Iveta, Ozere, Fernando, Baquero-Artigao, Maria, Tsolia, Tiago, Milheiro Silva, Matilde, Bustillo-Alonso, Andrea, Martín Nalda, Margherita, Mancini, Anna, Starshinova, Nicole, Ritz, Svetlana, Velizarova, Laura, Ferreras-Antolín, Florian, Götzinger, Olga, Bilogortseva, Vira, Chechenyeva, Marc, Tebruegge, Begoña, Santiago-García, Cristina, Russo, Buonsenso, Danilo, Noguera-Julian, Antoni, Moroni, Rossana, Hernández-Bartolomé, Angel, Fritschi, Nora, Lancella, Laura, Cursi, Laura, Soler-Garcia, Aleix, Krüger, Renate, Feiterna-Sperling, Cornelia, Sali, Michela, Lo Vecchio, Andrea, Scarano, Sara, Hernanz Lobo, Alicia, Espiau, Maria, Soriano-Arandes, Antonio, Cetin, Benhur Sirvan, Brinkmann, Folke, Ozere, Iveta, Baquero-Artigao, Fernando, Tsolia, Maria, Milheiro Silva, Tiago, Bustillo-Alonso, Matilde, Martín Nalda, Andrea, Mancini, Margherita, Starshinova, Anna, Ritz, Nicole, Velizarova, Svetlana, Ferreras-Antolín, Laura, Götzinger, Florian, Bilogortseva, Olga, Chechenyeva, Vira, Tebruegge, Marc, and Santiago-García, Begoña

Subjects
Pulmonary and Respiratory Medicine, Tuberculosis, Children, Diagnosis, Quantiferon
Abstract

RationaleIn 2016, a new interferon-gamma release assay (IGRA) was introduced, QuantiFERON-TB Gold Plus (QFT-Plus), claimed to have improved sensitivity in active tuberculosis (TB).ObjectivesThis study aimed to determine the performance of QFT-Plus, compared with previous generation IGRAs and the tuberculin skin test (TST), in children with TB in Europe.MethodsMulticentre, ambispective cohort study within the Paediatric Tuberculosis Network European Trials Group (ptbnet), a dedicated paediatric TB research network comprising >300 members, capturing TB cases Measurements and main results1001 TB cases from 16 countries were included (mean age (IQR) 5.6 (2.4–12.1) years). QFT-Plus was performed in 358, QFT Gold in-Tube (QFT-GIT) in 600, T-SPOT.TBin 58 and TST in 636 cases. The overall test sensitivities were: QFT-Plus 83.8% (95% CI 80.2% to 87.8%), QFT-GIT 85.5% (95% CI 82.7% to 88.3%), T-SPOT.TB77.6% (95% CI 66.9% to 88.3%) and TST (cut-off ≥10 mm) 83.3% (95% CI 83.3% to 86.2%). There was a trend for tests to have lower sensitivity in patients with miliary and/or central nervous system (CNS) TB (73.1%, 70.9%, 63.6% and 43.5%, respectively), and in immunocompromised patients (75.0%, 59.6%, 45.5% and 59.1%, respectively).ConclusionsThe results indicate that the latest generation IGRA assay, QFT-Plus, does not perform better than previous generation IGRAs or the TST in children with TB disease. Overall, tests performed worse in CNS and miliary TB, and in immunocompromised children. None of the tests evaluated had sufficiently high sensitivity to be used as a rule-out test in children with suspected TB.

Published
2022

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