Publications by authors named "Aguilera-Alonso D"
We evaluated the prevalence and characteristics of persistent signs and/or symptoms in children and young people (CYP) one year after hospitalization for acute COVID-19 compared with a control group of CYP hospitalized for other conditions. We conducted an observational study in three hospitals in Madrid, which included a group of children aged between 1 month and 18 years who were hospitalized due to acute COVID-19 from March 2020 to December 2021. We also selected a comparison group of patients hospitalized for other, unrelated conditions within the same month.
View Article and Find Full Text PDFThis study conducted in Madrid (Spain) between 2018 and 2023 shows a significant decrease in the pediatric bacterial community-acquired pneumonia cases during the COVID-19 pandemic, followed by a notable postpandemic increase surpassing prepandemic incidence. Streptococcus pneumoniae remains predominant, with an increasing prevalence of serotype 3, while Streptococcus pyogenes was the second most common pathogen.
View Article and Find Full Text PDFArticle Synopsis
- Klebsiella michiganensis is an emerging hospital pathogen that often carries antibiotic-resistance genes, including those for carbapenemases, prompting a redefined outbreak alert in a Spanish pediatric ward.
- The study analyzed 31 isolates of K. oxytoca with a focus on VIM-carbapenemase, using whole-genome sequencing to establish genetic relationships and identify resistance genes.
- The results confirmed an outbreak involving 18 cases across three wards, revealing complex interconnections and potential hidden reservoirs for the infection, underscoring the importance of genomic analysis in outbreak management.
Therapeutic monitoring of antibiotics and antifungals based on pharmacokinetic and pharmacodynamic (PK/PD) parameters is a strategy increasingly used for the optimization of therapy to improve efficacy, reduce the occurrence of toxicities, and prevent the selection of antimicrobial resistance, particularly in vulnerable patients including neonates and the critical or immunocompromised paediatric host. In neonates and children, infections account for a high percentage of hospital admissions, and anti-infectives are the most used drugs. However, paediatric PK/PD studies and the evidence regarding the efficacy and safety of some newly marketed antibiotics and antifungals-usually used off-label in paediatrics-to determine the optimal drug dosage regimens are limited.
View Article and Find Full Text PDFArticle Synopsis
- Immune-based TB diagnostic tests currently have low sensitivity in children and struggle to differentiate between latent TB infection (LTBI) and active TB disease.
- The study analyzed 17 biomarkers in plasma from children with confirmed TB, LTBI, and non-TB infections, finding significant biomarkers like IFN-γ and IL-2 that effectively predicted TB status.
- The IFN-γ/MCP-1 ratio emerged as the most promising combination for distinguishing between MTB-infected and non-infected children, suggesting a need for further research to improve pediatric TB diagnosis.
Therapeutic monitoring of antibiotics and antifungals based on pharmacokinetic and pharmacodynamic (PK/PD) parameters is a strategy increasingly used for the optimization of therapy to improve efficacy, reduce the occurrence of toxicities, and prevent the selection of antimicrobial resistance, particularly in vulnerable patients including neonates and the critical or immunocompromised paediatric host. In neonates and children, infections account for a high percentage of hospital admissions, and anti-infectives are the most used drugs. However, paediatric PK/PD studies and the evidence regarding the efficacy and safety of some newly marketed antibiotics and antifungals-usually used off-label in paediatrics-to determine the optimal drug dosage regimens are limited.
View Article and Find Full Text PDFTherapeutic monitoring of antibiotics and antifungals based on pharmacokinetic and pharmacodynamic parameters, is a strategy increasingly used for the optimization of therapy to improve efficacy, reduce the occurrence of toxicities, and prevent the selection of antimicrobial resistance, particularly in vulnerable patients including neonates and the critical or immunocompromised host. In neonates and children, infections account for a high percentage of hospital admissions and anti-infectives are the most used drugs. However, pediatric pharmacokinetic and pharmacodynamic studies and the evidence regarding the efficacy and safety of some newly marketed antibiotics and antifungals -usually used off-label in pediatrics- to determine the optimal drug dosage regimens are limited.
View Article and Find Full Text PDFCentral nervous system infections in children caused by group A Streptococcus are rare. This study, conducted across 52 hospitals in Spain from 2019 to 2023, identified 32 cases of central nervous system infections in children caused by group A Streptococcus, with a significant increase from October 2022 onward (1.1% vs.
View Article and Find Full Text PDFBackground: Pseudomonas aeruginosa bloodstream infections (PA-BSIs) are a serious disease and a therapeutic challenge due to increasing resistance to carbapenems. Our objectives were to describe the prevalence and risk factors associated with carbapenem resistance (CR) and mortality in children with PA-BSI.
Methods: A retrospective, multi-centre study was carried out, including patients aged <20 years with PA-BSI in four tertiary hospitals in Madrid (Spain) during 2010-2020.
Background: Antimicrobial resistance (AMR) has become a significant challenge in high-complexity healthcare settings.
Aim: To evaluate the prevalence of AMR in bloodstream isolates from high-complexity paediatric units in Spain over a nine-year period.
Methods: A retrospective observational multicentre study was conducted in three tertiary hospitals, analysing bloodstream isolates from patients aged <18 years admitted to the paediatric intensive care, neonatology, and oncology-haematology units between 2013 and 2021.
Objectives: To evaluate the impact of time to results (TTR) on the outcome of patients with carbapenemase-producing Enterobacterales bloodstream infections (CPE-BSI).
Methods: Times-series study conducted from January 2014 to December 2021, selecting patients with first CPE-BSI episodes. Periods of intervention were defined according to implementation of diagnostic bundle tests in the microbiology laboratory: pre-intervention (January 2014-December 2017) and post-intervention (January 2018-December 2021).
Consensus document on the management of febrile neutropenia in paediatric haematology and oncology patients of the Spanish Society of Pediatric Infectious Diseases (SEIP) and the Spanish Society of Pediatric Hematology and Oncology (SEHOP).
An Pediatr (Engl Ed)
June 2023
Article Synopsis
- Febrile neutropenia is a serious infection risk for children with blood or solid tumors, primarily due to chemotherapy-induced neutropenia, damaged barriers, and intravascular devices.
- Early recognition and tailored treatment are vital to enhance patient outcomes, necessitating the creation of standardized protocols for effective management.
- The document aims to provide consensus guidelines for treating febrile neutropenia in pediatric oncology, focusing on evaluation, treatment strategies, and supportive care while accommodating local patient needs and infection trends.
Article Synopsis
- A study examined cases of invasive Group A Streptococcus bloodstream infections (GAS-BSI) in children in Madrid from 2005 to 2017, finding 109 cases with an incidence of 4.3 episodes per 100,000 children per year.
- The study indicated a non-significant upward trend in incidence over time, with the majority of cases occurring in children under four years old, primarily presenting as primary bloodstream infections.
- Factors like respiratory distress were linked to increased severity, with 22% of affected children requiring admission to the pediatric intensive care unit; however, only 1.8% of cases resulted in death.
Article Synopsis
- The text discusses the application of monoclonal antibodies in treating a young patient with severe combined immunodeficiency who had a persistent SARS-CoV-2 infection.
- This treatment was crucial as the patient needed an urgent stem cell transplant to address his underlying health condition.
- Monoclonal antibodies were used to help manage the viral infection while preparing the patient for the transplant procedure.
Article Synopsis
- The study investigates acute Epstein-Barr virus (aEBV) infections in children under 16 and how they compare to cytomegalovirus (CMV) infections regarding symptoms and hospitalization risks.
- It includes a retrospective analysis of 149 children, highlighting that younger patients showed atypical symptoms and higher rates of EBV-CMV co-detection, which affected their hospitalization likelihood.
- Results indicate that hospitalization is linked to prior antibiotic use and anemia, with younger children presenting more unusual symptoms and more often being co-infected with CMV.
Infections caused by multidrug resistant Gram-negative bacteria are becoming a worldwide problem due to their increasing incidence and associated high mortality. Carbapenem-resistant bacteria such as Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii are the most important in clinical practice. The objective of these guidelines is to update the recommendations for the diagnosis and treatment of infections caused by these multidrug resistant bacteria.
View Article and Find Full Text PDFIntroduction: 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.
Scarce evidence exists about the best treatment for multi-system inflammatory syndrome (MIS-C). We analyzed the effects of steroids, intravenous immunoglobulin (IVIG), and their combination on the probability of discharge over time, the probability of switching to second-line treatment over time, and the persistence of fever 2 days after treatment. We did a retrospective study to investigate the effect of different treatments on children with MIS-C from 1 March 2020 to 1 June 2021.
View Article and Find Full Text PDFPosition statement of the Spanish Society of Paediatric Infectious Diseases on the introduction, implementation and assessment of antimicrobial stewardship programmes in paediatric hospitals.
An Pediatr (Engl Ed)
November 2022
Article Synopsis
- Antimicrobial resistance is rising as a major public health issue, with irrational use of antimicrobials being a key contributor, particularly among children who often receive inappropriate prescriptions.
- The implementation of antimicrobial stewardship programmes (ASPs) is critical in fighting this resistance and should be tailored specifically for paediatric patients due to their unique needs compared to adults.
- The Sociedad Española de Infectología Pediátrica (SEIP) aims to promote and provide resources for effective paediatric ASPs in Spanish hospitals to enhance patient care and combat antimicrobial resistance effectively.
SARS-CoV2 infection in pregnancy and exposed newborns is poorly known. We performed a longitudinal analysis of immune system and determined soluble cytokine levels in pregnant women infected with SARS-CoV2 and in their newborns. Women with confirmed SARS-CoV2 infection and their exposed uninfected newborns were recruited from Hospital General Universitario Gregorio Marañón.
View Article and Find Full Text PDFIn this cohort of 42 adolescents with a previous multisystem inflammatory syndrome (MIS-C) diagnosis, 32 (76.2%) were vaccinated with COVID-19 vaccines, with a low incidence of relevant adverse events. More importantly, no new MIS-C or myocarditis occurred after a median of 10 weeks (range 5.
View Article and Find Full Text PDF