Publications by authors named "Martha I Alvarez-Olmos"
Background: Multisystem inflammatory syndrome (MIS-C) represents a diagnostic challenge because of its overlap with Kawasaki disease, Kawasaki disease shock syndrome, and toxic shock syndrome. Macrophage activation syndrome (MAS) is a frequently fatal complication of various pediatric inflammatory disorders and has been reported in MIS-C. Early diagnosis and prompt initiation by immune modulating therapies are essential for effectively managing MAS.
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- The study aimed to investigate the epidemiology and outcomes of multisystem inflammatory syndrome in children (MIS-C) across 16 Latin American countries from August 2020 to June 2022.
- Out of 1239 children with MIS-C, the majority were previously healthy, with common symptoms including abdominal pain and conjunctival injection, and nearly half required intensive care.
- The overall death rate was 4.88%, notably higher for those not initially diagnosed with MIS-C, emphasizing the need for improved awareness and early detection of the syndrome.
Article Synopsis
- * 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
Article Synopsis
- Multisystem inflammatory syndrome in children (MIS-C) related to COVID-19 shows varied severity, with a lower mortality rate in wealthier countries, highlighting differences in outcomes across regions.
- In a study of 1,239 children across 16 Latin American countries, the majority were previously healthy, but nearly half required admission to the pediatric intensive care unit (PICU), where they experienced more severe symptoms like myocardial dysfunction.
- Key risk factors for PICU admission included being over six years old, experiencing shock or seizures, having low platelet counts, elevated inflammatory markers, and abnormalities on chest X-rays, with an overall mortality rate of 4.8%, which is notably higher than in high-income countries.
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.
Article Synopsis
- Acute bacterial meningitis (ABM) is a serious health issue that has reappeared in Colombia after new vaccines were introduced, as some types of bacteria are not covered by these vaccines.
- A study across 17 hospitals in Colombia looked at how cases of meningitis changed before and after the PCV10 vaccine was used.
- The study found that while some types of bacteria decreased, others, like Spn19A, became more common and showed resistance to medicines, meaning they are harder to treat; there was also a rise in death rates from this disease.
Diabetic ketoacidosis is a life-threatening complication associated with type 1 diabetes (T1D). Recent evidence suggests that SARS-CoV-2 could trigger diabetic ketoacidosis in type 1 diabetes susceptibility and previous insulitis; however, the data on SARS-CoV-2-infected patients with diabetic ketoacidosis as their type 1 diabetes are still limited. We report a 13-year-old Latinamerican male with symptoms and laboratory tests diagnostic of diabetic ketoacidosis and positive SARS-CoV-2 reverse transcription polymerase chain reaction, who required mild COVID-19 care management, fluid resuscitation, and insulin infusion at a regular dose, without further complications after the acute infection.
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- The Consensus document focuses on managing febrile neutropenia episodes in children with cancer, providing comprehensive guidelines for prevention, diagnosis, and treatment.
- It includes specific recommendations regarding hospital admission procedures, antimicrobial therapy management, and diagnosis of invasive fungal infections.
- The aim is to enhance care quality and equity across Latin American healthcare centers treating children with cancer.
Epidemiological characteristics and serotype distribution of culture-confirmed pediatric pneumococcal pneumonia before and after PCV 10 introduction, a multicenter study in Bogota, Colombia, 2008-2019.
Vaccine
May 2022
Article Synopsis
- - PCVs have helped reduce pneumonia in children, with Colombia starting mass vaccination using PCV10 in 2012, leading to the comparison of pneumonia cases before (2008-2011) and after (2014-2019) vaccination.
- - The study analyzed 370 cases revealing a significant drop in occurrences of serotypes 1 and 14, while serotypes 19A, 3, and 6A surged, indicating more serious cases needing increased hospital care and longer antibiotic treatment.
- - Findings suggest that PCV10 decreased specific serotypes but allowed for the rise of more severe strains, emphasizing the need for transitioning to a more effective vaccine like PCV13 to combat evolving pneumonia challenges.
Mortality and clinical characteristics of multisystem inflammatory syndrome in children (MIS-C) associated with covid-19 in critically ill patients: an observational multicenter study (MISCO study).
BMC Pediatr
November 2021
Background: The clinical presentation and severity of Multisystem Inflammatory Syndrome in Children associated with COVID-19 (MIS-C) is widespread and presents a very low mortality rate in high-income countries. This research describes the clinical characteristics of MIS-C in critically ill children in middle-income countries and the factors associated with the rate of mortality and patients with critical outcomes.
Methods: An observational cohort study was conducted in 14 pediatric intensive care units (PICUs) in Colombia between April 01, 2020, and January 31, 2021.
Article Synopsis
- The study analyzed 1,418 Kawasaki disease (KD) patients from Latin America treated between 2009 and 2017, comparing those who received only IVIG with those who received adjunctive therapies.
- Most patients were male and hospitalized early, with steroid use being the most common adjunctive treatment for IVIG-resistance, followed by extra doses of IVIG, while biologics like infliximab were rarely used.
- The findings indicate that children receiving adjunctive therapies often had worse indicators, like lower platelet and albumin levels, and highlight the need for further research on treatment barriers in this region.
To characterize the clinical presentation and outcomes of Kawasaki disease (KD) in infants <6 months of age as compared to those ≥6 months in Latin America. We evaluated 36 infants <6 months old and 940 infants ≥6 months old diagnosed with KD in Latin America. We compared differences in laboratory data, clinical presentation, treatment response, and coronary artery outcomes between the two cohorts.
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- The introduction of pneumococcal conjugate vaccines (PCV) has significantly reduced the incidence of invasive pneumococcal disease (IPD), leading to a decrease in vaccine-associated serotypes, but has resulted in the emergence of non-vaccine serotypes like 19A.
- A study conducted on pediatric patients with IPD from 2008 to 2017 in Bogota examined cases related to the implementation of the PCV10 vaccine, focusing on various infections and analyzing demographic and clinical data.
- The prevalence of IPD caused by serotype 19A increased from 4.4% (2008-2011) to 32.4% (2014-2017), with pneumonia being the
USA300-related methicillin-resistant Staphylococcus aureus clone is the predominant cause of community and hospital MRSA infections in Colombian children.
Int J Infect Dis
August 2014
Objective: Community-genotype methicillin-resistant Staphylococcus aureus (CG-MRSA) isolates are known to be more virulent and clinically aggressive in children. The goal of the present study was characterize the molecular epidemiology of MRSA isolates causing infections in Colombian children.
Methods: An observational and prospective study was conducted between April 2009 and June 2011 at 15 hospitals in Bogotá, Colombia.
Detection of a new community genotype methicillin-resistant Staphylococcus aureus clone that is unrelated to the USA300 clone and that causes pediatric infections in Colombia.
J Clin Microbiol
February 2013
Article Synopsis
- A new clone of community genotype methicillin-resistant Staphylococcus aureus (CG-MRSA) has been identified in Colombia, separate from the commonly known USA300 strain.
- This new clone is characterized by a specific spa type (t1635) and lacks the ACME genetic element.
- The emergence of this clone suggests an evolving landscape of MRSA infections, particularly among children in Latin America.
Pediatric cases from Colombia caused by a Panton-Valentine Leukocidin-positive community-acquired methicillin-resistant Staphylococcus aureus ST8-SCCmecIVc clone.
Pediatr Infect Dis J
October 2009
Objective: The objective of this study was to survey middle adolescents for the presence of vaginal lactobacilli, lactobacilli-specific immune sensitization, and correlates of vaginal immunity with lactobacilli and bacterial vaginosis (BV).
Methods: A cohort of 89 female adolescents were evaluated for the presence of vaginal lactobacilli species, H2O2-producing species, and the prevalence of BV. Cytokines and antibodies in cervicovaginal lavages were detected and peripheral blood lymphocyte (PBL) responses to Lactobacillus crispatus were evaluated.