Sandra Grenon

Prospective study of enteropathogens in two communities of Misiones, Argentina

Children under five years of age, from two communities of different socio-economic strata (97 from Zaiman and 55 from Las Dolores) were examined epidemiologically during 2 years, by means of quarterly visits of the working team, who carried out the collection of faecal samples. During the study, one or more enteropathogens were identified in 73.9% of samples in children from Zaiman and in 58.3% of the samples from Las Dolores, being associated to diarrhoea in 70.5% and to asymptomatic infections in 65.7%. The number of diarrheic episodes was higher in Zaiman (15.45%) than in Las Dolores (12.35%), being more frequent in the spring-summer seasons. In Zaiman, the bacterial enteropathogen proportion was relevantly higher (p < 0.005) in children with diarrhoea, whereas the presence of parasites was more frequent in asymptomatic children (p < 0.01). Rotavirus had an even distribution within diarrheic and asymptomatic children. In Las Dolores, no relevant differences were found in the detection of enteroparasites between diarrheic and asymptomatic children. Mixed infections were detected; enterotoxigenic Escherichia coli (ETEC)-rotavirus and ETEC-parasites being the most frequent ones. ETEC was involved in 85% of these infections. These data, together with the high enteropathogen carriage, suggest an elevated level of environmental contamination. The latter plays an important role in diarrheic diseases, and added to the most extreme poverty, it affects childrens lives.

Meningitis neumocócica en niños menores de 15 años. Dieciséis años de vigilancia epidemiológica en Misiones, Argentina

We report the results of pneumococcal meningitis surveillance conducted at the Provincial Pediatric Hospital of Posadas, Misiones (Argentina), before the con...

Distribución de serotipos y perfiles de sensibilidad a los antimicrobianos de cepas de Streptococcus pneumoniae aisladas en niños en Misiones, Argentina

Antecedentes. El objetivo de este trabajo fue evaluar los patrones de resistencia antibiotica local y los serotipos de Streptococcus pneumoniae implicados en enfermedades invasivas en pacientes pediatricos del Hospital Provincial de Pediatria de Misiones, Argentina. Metodos. Se estudiaron 101 cepas aisladas de ninos a partir de muestras esteriles, entre junio de 1998 y junio de 2001. Las muestras se procesaron por el metodo habitual, y los patrones de resistencia antibiotica se determinaron segun pautas del National Committee for Clinical Laboratory Standards (NCCLS), por tecnicas de difusion y dilucion. La serotipificacion se efectuo mediante la reaccion de Quellung. Resultados. El 62% de las neumonias, el 70% de las neumonias con derrame y de las meningitis y 78% de las sepsis correspondieron a ninos menores de 2 anos de edad (74% del total de pacientes). Se identificaron 12 serotipos entre 71 cepas analizadas. Los tipos 14 (37,1%), 5 (21,4%), 1 (10%), 6A/6B (7,1%), 9N y 19A (5,7%) y 9V (4,3%) fueron los mas frecuentes. Se observo sensibilidad disminuida a penicilina en el 39% de los aislamientos, el 17,5% de los cuales presento resistencia intermedia y el 21,5% alto nivel de resistencia. Para ningun aislamiento la concentracion inhibitoria minima (CIM) fue superior a 4 µg/ml. La resistencia a penicilina quedo circunscrita a cinco serotipos, correspondiendo en el 84% de los casos al 14. Entre 71 aislamientos en que se efectuo la CIM a cefotaxima, 50 presentaron un valor menor o igual a 0,5 µg/ml; 18 una CIM de 1 µg/ml y tres de 2 µg/ml. No se detectaron cepas cuya CIM fuera superior a 2 µg/ml. El 22% de los aislamientos fue resistente a tetraciclina, el 48% a trimetoprima-sulfametoxazol, el 11% a cloranfenicol y el 6,8% a eritromicina. Ningun aislamiento fue resistente a vancomicina, ofloxacino ni rifampicina. Los patrones de resistencia combinada mas comunes, entre las cepas no sensibles a penicilina, fueron: penicilina-trimetoprima-sulfametoxazol (20%) seguido de penicilina-cefotaxima-trimetoprima-sulfametoxazol (7%; 3 aislamientos con CIM a cefotaxima = 2 µg/ml) y penicilina-trimetoprima-sulfametoxazol-cloranfenicol (5%). Conclusiones. Los patrones de resistencia y los tipos capsulares circulantes locales observados en este trabajo permiten adecuar esquemas terapeuticos a nuestra realidad y brindan informacion al equipo medico para evaluar el uso de vacunas como herramienta de prevencion y control de las infecciones invasivas por S. pneumoniae.

Tos convulsa: características clinicoepidemiológicas de 20 casos confirmados atendidos en el Hospital Pediátrico de la provincia de Misiones

Pertussis or whooping cough is a respiratory disease that has emerged in recent years in several countries including Argentina. The aim is to retrospectively describe clinical and epidemiological characteristics of 20 patients in the Pediatric Hospital of Misiones with confirmed diagnosis of whooping cough, according to criteria set by WHO and CDC, during the years 2005 and 2006. The median age was 4 months, 13 were male (65%). Fourteen patients (70%) were younger than 6 months and 9 (45%) younger than 3 months. All had cough (average duration of 7.6 days), 5 (25%) paroxysmal cough and 1 (5%) apnea and cyanosis. Two children died. Sixteen (80%) had not the three doses of vaccine quadruple, 7 children (35%) were younger than 3 months and had no dose. The disease remains a public health problem affecting not only children but also adults.