Publications by authors named "Eduardo Lopez Medina"

Background: Dengue is hyperendemic in Colombia. It imposes a substantial economic burden on patients, caregivers, society, and the national health system. We intend to identify and synthesize the evidence regarding the economic burden of dengue in Colombia.

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Of 319 children with invasive candidiasis, 67 (21%) transitioned from intravenous to enteral antifungal therapy. Eight (12%) transitioned back to intravenous antifungal therapy, one due to perceived treatment failure defined by clinical progression or worsening. Global treatment response at study completion was successful in 66 participants who transitioned to enteral therapy.

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Dengue is the most important viral vector-borne disease in the tropics, with Colombia being one of the most affected countries. In this context, it is essential to identify and synthesize the existing evidence on the epidemiology of dengue in Colombia. A systematic review (PROSPERO CRD42021257985) was conducted by searching for epidemiological data in populations with suspected or confirmed dengue in Colombia from 2012 to 2020.

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  • - Dengue cases reached an all-time high in 2023-2024, particularly in Valle del Cauca, Colombia.
  • - The study identified all four serotypes of the dengue virus and various lineages, indicating a diverse viral presence during the outbreak.
  • - Researchers believe that environmental factors, especially climatic conditions, played a significant role in the surge of dengue cases in Colombia.
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  • The study focuses on understanding the molecular epidemiology of Treponema pallidum subspecies pallidum (TPA) to aid in the development of a global syphilis vaccine by analyzing clinical data and specimens from early syphilis patients across multiple countries.* -
  • Enrolling 233 patients with primary and secondary syphilis from China, Colombia, Malawi, and the USA, researchers utilized whole-genome sequencing (WGS) to study TPA strains, revealing important demographic information and a significant presence of HIV co-infections among participants.* -
  • The findings highlighted a dominance of SS14-lineage strains with geographical distribution patterns, confirming genetic differences in the Nichols-lineage strains, which could inform future vaccine strategies and
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  • RSV is the top cause of severe respiratory infections in children and has seen a rise in cases post-pandemic, especially in low- and middle-income countries.
  • Traditional treatments have been mainly supportive, but new preventive measures like long-acting monoclonal antibodies and vaccinations for pregnant women are becoming available.
  • The Latin American Pediatric Infectious Diseases Society (SLIPE) is assessing the impact of RSV in the LAC region and recommending new strategies for prevention.
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  • Global dengue cases hit record highs in 2023-24, with significant outbreaks seen in Valle del Cauca, Colombia.
  • Researchers found all four dengue virus serotypes and various lineages present in the area during the outbreak.
  • The study indicates that factors beyond just the virus types, such as climate conditions, might be contributing to the surge in cases.
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Background: Venereal syphilis, caused by the spirochete Treponema pallidum subsp. pallidum (TPA), is surging worldwide, underscoring the need for a vaccine with global efficacy. Vaccine development requires an understanding of syphilis epidemiology and clinical presentation as well as genomic characterization of TPA strains circulating within at-risk populations.

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Background: Dengue is an increasing threat to global health. This exploratory analysis evaluated the immunogenicity, safety, and vaccine efficacy (VE) of a live-attenuated tetravalent dengue vaccine (TAK-003) in participants enrolled in the phase 3 DEN-301 trial (NCT02747927), stratified by baseline age (4-5 years; 6-11 years; or 12-16 years).

Methods: Participants were randomized 2:1 to receive 2 doses of TAK-003, administered 3 months apart, or placebo.

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  • Infections significantly impact pediatric health worldwide, prompting the Staphylo Research Network to study pediatric patients in Colombia between 2018 and 2021, focusing on their epidemiological and microbiological characteristics.
  • The study analyzed 8,157 culture isolations from 20 centers, noting that methicillin-sensitive Staphylococcus aureus (MSSA) was more common than methicillin-resistant Staphylococcus aureus (MRSA), particularly in different regional hospitals.
  • Findings highlight that while MSSA was dominant, regional variations in MRSA prevalence exist, and most strains showed susceptibility to common antibiotics, emphasizing the need for ongoing infection monitoring in children.
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Invasive fusariosis (IF) is a life-threatening opportunistic infection that affects vulnerable hosts. We conducted a multicenter and multinational retrospective study to characterize the natural history and clinical management of IF in pediatric cancer patients. We selected patients <18 years old who were sequentially hospitalized in 10 Latin American medical centers with a diagnosis of IF between 2002 and 2021.

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  • * A total of 530 patients were reported, with the majority exhibiting pneumonia; the study highlighted high rates of ICU admissions (50.6%) and notable resistance to antibiotics among meningial and non-meningial isolates.
  • * The findings indicated a decrease in PCV10 serotypes but an increase in the prevalence of serotypes 19A and 6C, leading to Colombia's decision to switch to the PCV13 vaccine in July 202
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  • The study investigated how previous vaccinations for Yellow Fever (YF) and Japanese Encephalitis (JE) affect the effectiveness of the dengue vaccine candidate, TAK-003, in children aged 4-16 years.
  • Out of 20,071 participants, different levels of vaccine efficacy were observed: 55.7% in those previously vaccinated for YF, 77.8% for JE, and 53.5% for those with no prior vaccinations, but these results were influenced by the regional distribution of dengue virus serotypes.
  • Overall, the findings indicate that prior YF or JE vaccinations do not significantly impact the efficacy of TAK-003, which was well-tolerated across various epidemiological settings.
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  • The first 1,000 days of life are vital for child development, but there's a lack of information on influencing factors in the Latin America and the Caribbean (LAC) region.
  • In May 2022, the Latin American Pediatric Infectious Diseases Society (SLIPE) organized a workshop with experts to discuss key issues affecting childhood development and maternal infant health in LAC.
  • The goal was to identify priorities and create actionable recommendations to improve maternal and infant care, focusing on reducing mortality from infections and preventable diseases during this critical developmental period.
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  • Incidence rates of respiratory syncytial virus-associated lower respiratory tract illness (RSV-LRTI) in infants were assessed in low- and middle-income countries (LMICs) as existing data was limited.
  • The study followed 2,094 infants from 10 LMICs over one year, using surveillance and testing to identify cases during the COVID-19 pandemic.
  • Results indicated a low incidence of RSV-LRTI (1.5% of infants) and all-cause lower respiratory tract infections, likely influenced by reduced viral activity during the pandemic.
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  • * In 2021, experts from 13 countries in the region gathered to address vaccination challenges and propose strategies to prevent the return of vaccine-preventable diseases.
  • * Suggested strategies for increasing vaccination coverage include using combination vaccines, enhancing surveillance, improving school engagement, promoting vaccine education and equity, and fostering collaborations among medical societies.
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Background: Adjunctive diagnostic studies (aDS) are recommended to identify occult dissemination in patients with candidemia. Patterns of evaluation with aDS across pediatric settings are unknown.

Methods: Candidemia episodes were included in a secondary analysis of a multicenter comparative effectiveness study that prospectively enrolled participants age 120 days to 17 years with invasive candidiasis (predominantly candidemia) from 2014 to 2017.

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  • The study investigates the risk factors for carbapenem-resistant Enterobacterales (CRE) bloodstream infections in children with cancer or post-hematopoietic stem cell transplant (HSCT) over a nine-year period in Colombia.
  • Researchers analyzed data to create and validate three prediction models to identify the risk of CRE based on infection types and antibiotic use.
  • Key findings show that infections from Klebsiella spp. and recent carbapenem use significantly increase CRE risk, with a predictive model demonstrating high specificity and effectiveness for identifying patients who may not need CRE-active treatments.
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Objective: Zika virus infection has been associated to congenital zika syndrome (CZS) in newborns and is characterized by microcephaly, central/axial motor and sensory dysfunction, dysphagia among other previously described severe health complications. CZS is usually diagnosed postpartum by evident/apparent neural development problems. Although there are some reports of craniofacial/dentition development in CZS, several clinical oral aspects are still unknown.

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Background: The continuing increase in syphilis rates worldwide necessitates development of a vaccine with global efficacy. We conducted a multi-center, observational study to explore subsp. ( ) molecular epidemiology essential for vaccine research by analyzing clinical data and specimens from early syphilis patients using whole-genome sequencing (WGS) and publicly available WGS data.

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  • A study was conducted to evaluate the safety and immune response of a new RSV vaccine (ChAd155-RSV) in infants aged 6-7 months, comparing different doses and an active comparator.* -
  • The trial involved 201 infants, with results indicating that the vaccine had a safety profile comparable to existing childhood vaccines, and did not lead to adverse respiratory effects associated with RSV infections.* -
  • Higher doses of the ChAd155-RSV vaccine produced stronger immune responses, with increased antibody levels observed after vaccination, especially following the second dose.*
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  • Immunobridging is a method used to figure out how well vaccines work for people who weren’t tested in clinical studies, and it's helped create many vaccines.
  • Dengue is a virus spread by mosquitoes that used to mainly affect kids, but now it's a risk for both kids and adults around the world.
  • A study showed that the dengue vaccine (TAK-003) was tested on kids and found to work similarly in adults, suggesting it could be effective for everyone.
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  • - The study involved a dose-finding trial for the HilleVax bivalent vaccine (HIL-214) in children aged 6 months to 4 years across Panama and Colombia, with 120 participants per age cohort.
  • - Participants were divided into four groups receiving different vaccine formulations, and responses to the vaccine were measured at multiple intervals, showing significant antibody responses particularly after the second dose, especially in the younger cohort.
  • - The vaccine was well-tolerated with mild side effects reported, and the antibody levels remained elevated for at least 210 days post-vaccination, indicating potential for further development to protect young children from norovirus.
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Objectives: To describe the clinical presentation, management, and outcomes of Kawasaki disease (KD) in Latin America and to evaluate early prognostic indicators of coronary artery aneurysm (CAA).

Study Design: An observational KD registry-based study was conducted in 64 participating pediatric centers across 19 Latin American countries retrospectively between January 1, 2009, and December 31, 2013, and prospectively from June 1, 2014, to May 31, 2017. Demographic and initial clinical and laboratory data were collected.

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