Browsing by Author "Viviani, Tamara"
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- ItemFuente de infección de Bordetella pertussis en lactantes hospitalizados por coqueluche(SOC MEDICA SANTIAGO, 2011) Perret, Cecilia; Viviani, Tamara; Pena, Anamaria; Abarca, Katia; Ferres, MarcelaBackground: Despite pertussis vaccination, very young infants have the highest rates of morbidity and mortality caused by the microorganism. Aim: To determine the source of Pertussis infection in infants aged six months or less in Chile. Material and Methods: Twenty six household contacts of 10 young infants hospitalized with confirmed Pertussis were studied for the presence of Bordetella Pertussis by polymerase chain reaction (PCR). Clinical and demographic data were analyzed. Results: Respiratory symptoms were present in 20 (77%) contacts, being cough the most common. Pertussis cases were identified in every household and in 18 (72%) of the household members. Four members with B.pertussis were asymptomatic. Source of infection was identified in 80% (8/10) of the infant cases with ages ranging from 6 to 62 years. Half of primary cases had positive PR and their cough duration was significantly shorter compared to primary cases with negative PER. Conclusions: B. pertussis transmission to young infants occurred mainly within the household where adults are generally the source of the infection. Risk factors for infant infection are the same as in developed countries. Therefore, the same strategies, such as routine vaccination in adolescents and adults or cocoon strategy, will help to prevent this disease in infants. (Rev Med Chile 2011; 139: 448-454).
- ItemOccult bacteremia in Sotero del Rio Hospital. Experience after pneumococcal conjugated vaccine(SOC CHILENA INFECTOLOGIA, 2017) Budnik, Isolda; Sandoval, Alejandra; Prado, Alejandra; Labbe, Marcela; Pena, Anamaria; Viviani, TamaraBackground: Occult bacteremia (OB) is one of the possible diagnoses of children younger than 3 years with fever without source in the emergency room. Objective: describe OB in the era after introduction of pneumococcal vaccine in Chile. Patients and Methods: Prospective descriptive review of data of children with possible OB diagnosis, referred from the emergency department between 2010-2013. Results: Possible OB was diagnosed on 391 patients. 233 had focus, mainly respiratory virus and urinary tract infection. On 158 patients, probable BO was diagnosed, 20 had proven OB from which 15 had positive blood culture for Streptococcus pneumoniae. From these, 7 were fully or partially vaccinated. The serotype was identified on 14 cases: 6 were PCV10 vaccine serotypes (none of them vaccinated), 2 were serotype related (both partially vaccinated) and 6 were non vaccine serotypes (partially or totally vaccinated). Discussion: It is necessary to improve diagnostic methods for respiratory viruses and urinary tract infections and try to expand coverage of pneumococcal conjugated vaccines in the pediatric population in order to reduce the risk of invasive pneumococcal disease in Chile.
- ItemPresentation and Outcomes of Kawasaki Disease in Latin American Infants Younger Than 6 Months of Age: A Multinational Multicenter Study of the REKAMLATINA Network(2020) Moreno, Elizabeth; Garcia, S. Diana; Bainto, Emelia; Salgado, Andrea P.; Parish, Austin; Rosellini, Benjamin D.; Ulloa-Gutierrez, Rolando; Garrido-Garcia, Luis M.; Duenas, Lourdes; Estripeaut, Dora; Luciani, Kathia; Rodriguez-Quiroz, Francisco J.; del Aguila, Olguita; Camacho-Moreno, German; Gomez, Virgen; Viviani, Tamara; Alvarez-Olmos, Martha, I; de Souza Marques, Heloisa Helena; Faugier-Fuentes, Enrique; Saltigeral-Simental, Patricia; Lopez-Medina, Eduardo; Mino-Leon, Greta; Beltran, Sandra; Martinez-Medina, Lucila; Pirez, Maria C.; Cofre, Fernanda; Tremoulet, Adriana H.Objective:To characterize the clinical presentation and outcomes of Kawasaki disease (KD) in infants Methods: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. Results:The majority (78.1%) of infants and children >= 6 months of age were initially diagnosed with KD, as compared to only 38.2% of infants <6 months. Clinical features of KD were more commonly observed in the older cohort: oral changes (92 vs. 75%,P= 0.0023), extremity changes (74.6 vs. 57.1%,P= 0.029), and cervical lymphadenopathy (67.6 vs. 37.1%,P= 0.0004). Whether treated in the first 10 days of illness or after the 10th day, infants <6 months were at greater risk of developing a coronary artery aneurysm compared to KD patients >= 6 months treated at the same point in the course of illness [ <= 10 days (53.8 vs. 9.4%,P= 0.00012); >10 days (50 vs. 7.4%,P= 0.043)]. Conclusion:Our data show that despite treatment in the first 10 days of illness, infants <6 months of age in Latin America have a higher risk of developing a coronary artery aneurysm. Delay in the diagnosis leads to larger coronary artery aneurysms disproportionately in these infants. Thus, suspicion for KD should be high in this vulnerable population.
- ItemRisk Factors Associated With Invasive Fungal Disease in Children With Cancer and Febrile Neutropenia A Prospective Multicenter Evaluation(LIPPINCOTT WILLIAMS & WILKINS, 2010) Villarroel, Milena; Aviles, Carmen L.; Silva, Pamela; Guzman, Ana M.; Poggi, Helena; Alvarez, Ana M.; Becker, Ana; O'Ryan, Miguel; Salgado, Carmen; Topelberg, Santiago; Tordecilla, Juan; Varas, Monica; Viviani, Tamara; Zubieta, Marcela; Santolaya, Maria E.Background: Empiric antifungal treatment has become standard of care in children with cancer and prolonged fever and febrile neutropenia (FN), with the downside that it leads to significant over treatment. We characterized epidemiologic, clinical, and laboratory features of invasive fungal disease (IFD) in children with cancer and FN with the aim to identify risk factors for IFD that can aid in better selecting children who require antifungal treatment.
- ItemUse of Adjunctive Therapy in Acute Kawasaki Disease in Latin America(2020) Fortuna-Reyna, Brenda; Bainto, Emelia V.; Ulloa-Gutiérrez, Rolando; Garrido-García, Luis M.; Estripeaut, Dora; del Águila, Olguita; Gómez, Virgen; Faugier-Fuentes, Enrique; Miño-León, Greta; Beltrán, Sandra; Cofré, Fernanda; Chacón-Cruz, Enrique; Saltigeral-Simental, Patricia; Martínez-Medina, Lucila; Dueñas, Lourdes; Luciani, Kathia; Rodríguez-Quiroz, Francisco J.; Camacho-Moreno, Germán; Viviani, Tamara; Álvarez-Olmos, Martha I.; de Sousa Marques, Heloisa Helena; López-Medina, Eduardo; Pirez, María C.; Tremoulet, Adriana H.; Borzutzky Schachter, Arturo; Kawasaki Disease REKAMLATINA Network Study GroupObjective: To characterize the use of adjunctive therapy in Kawasaki disease (KD) in Latin America. Methods: The study included 1,418 patients from the Latin American KD Network (REKAMLATINA) treated for KD between January 1, 2009, and May 31, 2017. Results: Of these patients, 1,152 received only a single dose of IVIG, and 266 received additional treatment. Age at onset was similar in both groups (median 2 vs. 2.2 years, respectively). The majority of patients were male (58 vs. 63.9%) and were hospitalized with the first 10 days of fever (85.1 vs. 84.2%). The most common adjunctive therapy administered was steroids for IVIG-resistance, followed by additional doses of IVIG. The use of biologics such as infliximab was limited. KD patients who received adjunctive therapy were more likely to have a lower platelet count and albumin level as well as a higher Z score of the coronary arteries. Conclusion: This is the first report of adjunctive therapies for KD across Latin America. IVIG continues to be the initial and resistance treatment, however, steroids are also used and to a lesser extent, biological therapy such as infliximab. Future studies should address the barriers to therapy in children with acute KD throughout Latin America