Moira Taicz

Garrahan Hospital

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Rosa Bologna

Garrahan Hospital

Guadalupe Pérez

Garrahan Hospital

María Teresa Rosanova

Garrahan Hospital

Vanesa Reijtman

Garrahan Hospital

Silvina Ruvinsky

Garrahan Hospital

Soledad Martiren

Garrahan Hospital

María Guadalupe Juárez Pérez

Garrahan Hospital

Laura Inda

Garrahan Hospital

Magali Garcia

Capital Allergy and Respiratory Disease Center

Alejandra Mastroianni

Garrahan Hospital

Cooperative Institutions

Garrahan Hospital

Universidad Nacional Autónoma de México

Instituto de Investigación Sanitaria del Hospital Clínico San Carlos

University College London

MRC Clinical Trials Unit at UCL

Hospital Clínico San Carlos

University of Padua

Inserm

Medical Research Council

Joint Clinical Research Centre

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Evaluación del valor de la proteína C reactiva y de la procalcitonina en la predicción de infección y mortalidad en los niños quemados

Archivos Argentinos de Pediatria (2014)

María Teresa Rosanova Nidia Tramonti Moira Taicz Soledad Martiren Hugo Basílico

C-reactive protein (CRP) and procalcitonin(PCT) levels may distinguish between a systemic inflammatory response and an infection in burn children.To establish the operative capability of CRP and PCT to diagnose infections and mortality.Burn patients admitted to the hospital with clinical suspicion of an infection were included. CRP and PCT were measured and their operative diagnostic capabilities were calculated.Forty-eight patients (p) were included.Their median age was 49 months old (r: 17-86).The median burned surface area was 40% (r: 30-48%); 28 p (58%) had type AB and type B burn wounds. Infection was confirmed in 32 p (66.7%);the most common infection was burn-related sepsis (24 p, 75%), followed by burn wound infection (6 p, 19%). Eight patients (17%) died.It was not possible to establish CRP sensitivity and specificity because it was high in all patients,regardless of mortality, survival or the presence of infection. In relation to infections, PCT had a 90.6% sensitivity (95% confidence interval [CI]:75.8-96.8%), a 18.8% specificity (95% CI: 6.6-43%),a 69% positive predictive value (PPV) and a 50%negative predictive value (NPV). In relation to 30-day mortality, sensitivity was 100% (95% CI:67.6-100%), specificity 15% (95% CI: 7.1-29.1%),PPV 19% (95% CI: 10-33.3%) and NPV 100%(95% CI: 61-100%).In pediatric burn patients, neither CRP nor PCT showed an adequate operative capability to detect an infection or a fatal outcome.

Procalcitonin

10.5546/aap.2015.36

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Effectiveness of a program to improve antibiotic use in children hospitalized in a children’s tertiary care facility in Argentina

Archivos Argentinos de Pediatria (2014)

Juan P. Garrahan Silvina Ruvinsky Andrea Lo Monaco Guadalupe Pérez Moira Taicz

Introduction.Inadequate antibiotic use is associated with an increased emergence of resistant microorganisms, higher morbidity and mortality rates, and an impact on public health.Objective.To assess the effectiveness of a program aimed at improving the use of antimicrobials in patients hospitalized at Hospital Garrahan.Material and Methods.Prospective, longitudinal, before and after study with no control group.Study period: From November 1 st , 2010 to June 30 th , 2011.Patients receiving parenteral antibiotics were included.Newborn infants, burned patients and those receiving prophylactic antibiotics were excluded.The periods before and after implementing discussion and monitoring workshops for antibiotic prescription and distributing treatment guidelines were compared.An univariate analysis and a multiple logistic regression study were performed (STATA 8.0).Results.In the pre-intervention period, 376 patients were included; of them, 35.6% had received inadequate treatment.The multiple regression analysis showed that the endpoints for inadequate antibiotic use were acute lower respiratory tract infection (OR: 3.80; 95% CI: 1.35-3.26;p = 0.04), fever without a source in hospitalized patients (OR: 5.55; 95% CI: 2.43-12.6;p < 0.01), and febrile neutropenia (OR: 0.29; 95% CI: 0.10-0.7;p < 0.01).In the post-intervention period, 357 patients were included; 21.5% had received inadequate treatment.A reduction in inadequate antibiotic prescription was observed compared to the pre-intervention period (p < 0.01).The multiple regression analysis showed that endpoints for inadequate use were skin and soft tissue infections (OR: 0.33; 95% CI: 0.13-0.93;p = 0.035), and febrile neutropenia (OR: 0.48; 95% CI: 0.22-0.94;p= 0.04). Conclusion.The program was effective and allowed to improve antibiotic prescription practices in hospitalized children.

Tertiary care

Tertiary level

10.5546/aap.2014.eng.124

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Assessment of C-reactive protein and procalcitonin levels to predict infection and mortality in burn children

Archivos Argentinos de Pediatria (2014)

Juan P. Garrahan María Teresa Rosanova Nidia Tramonti Moira Taicz Soledad Martiren

C-reactive protein (CRP) and procalcitonin (PCT) levels may distinguish between a systemic inflammatory response and an infection in burn children.Objectives.To establish the operative capability of CRP and PCT to diagnose infections and mortality.Methods.Burn patients admitted to the hospital with clinical suspicion of an infection were included.CRP and PCT were measured and their operative diagnostic capabilities were calculated.Results.Forty-eight patients (p) were included.Their median age was 49 months old (r: 17-86).The median burned surface area was 40% (r: 30-48%); 28 p (58%) had type AB and type B burn wounds.Infection was confirmed in 32 p (66.7%); the most common infection was burn-related sepsis (24 p, 75%), followed by burn wound infection (6 p, 19%).Eight patients (17%) died.It was not possible to establish CRP sensitivity and specificity because it was high in all patients, regardless of mortality, survival or the presence of infection.In relation to infections, PCT had a 90.6% sensitivity (95% confidence interval [CI]: 75.8-96.8%),a 18.8% specificity (95% CI: 6.6-43%), a 69% positive predictive value (PPV) and a 50% negative predictive value (NPV).In relation to 30-day mortality, sensitivity was 100% (95% CI: 67.6-100%), specificity 15% (95% CI: 7.1-29.1%),PPV 19% (95% CI: 10-33.3%)and NPV 100% (95% CI: 61-100%).Conclusions.In pediatric burn patients, neither CRP nor PCT showed an adequate operative capability to detect an infection or a fatal outcome.

Procalcitonin

Pediatric burn

10.5546/aap.2015.eng.36

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Citations (21)

P-1172. Staphylococcus Aureus Long-Term Catheter-Related Bloodstream Infection in Children: Clinical Features and Outcome

Open Forum Infectious Diseases (2025)

Guadalupe Pérez Mariel Merñiez Eduardo Padilla Moira Taicz Fernando Berrondo

Abstract Background Staphylococcus aureus long-term catheter-related bloodstream infection (LT-CRBI) are a frequent cause of morbidity and mortality. In Staphylococcus aureus LT-CRBI, it is recommended to remove the catheter. However, in pediatrics, management without catheter removal is often necessary. Aims to describe the clinical characteristics and outcome of Staphylococcus aureus LT- CRBI, to cmpare the clinical features and outcome according to removal or retention of the catheter Methods Retrospective cohort study. All patients with Staphylococcus aureus LT-CRBI from 1/1/2018 to 12/31/2022 in a pediatric hospital were included. Episodes of relapse of bacteremia were excluded. LT-CRBI was defined according to CDC criteria. Results Forty-five patients were included. Median age was 80 months (IQR 27-137). All patients had any underlying disease. Most common comorbidities were onco-hematological disease 27 patients (60%), intestinal failure 5 (11%), chronic kidney disease 3 (7%). Thirty-three were under immunosuppressive treatment (73%). Median length of bacteremia was 4 days (IQR 3-5) Five patients presented metastatic infection (11%) including 2 patients with pneumonia, 2 thrombophlebitis and 1 soft tissue infection. Twenty-two catheters (49%) were removed. Reasons for removal were: mechanical dysfunction in 6 patients, catheter was not being used in 5 patients, tunnel or pocket infection in 5, septic shock 3 and persistent bacteremia in 3. Two patients died related to infection (4%). Staphylococcus aureus methicillin sensitive predominated (78%). Comparing patients with catheter removal vs retained: there were no differences in epidemiological, clinical features and outcome (metastatic infection 13% vs 9%, intensive care admission 3% vs 3%, length of bacteremia 4 days in both groups, mortality 20% vs 17%, respectively) Conclusion In this cohort of children with Staphylococcus aureus LT- CRBI, catheters were maintained in 51% of patients. No difference in outcome or complications was observed. Disclosures All Authors: No reported disclosures

Bloodstream infection

10.1093/ofid/ofae631.1358

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Impact of a Program of Rational Antibiotic Use and New Technology for Early Detection and Treatment of Gram-Negative Bacteremia in a Pediatric Referral Hospital

Open Forum Infectious Diseases (2016)

Silvina Ruvinsky Moira Taicz Soledad Martiren Guadalupe Pérez Soledad González

Bacteremia

Gram

10.1093/ofid/ofw172.549

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Motivos de la prescripción inadecuada de antibióticos en un hospital pediátrico de alta complejidad Reasons for inappropriate prescribing of antibiotics in a high-complexity pediatric hospital

DOAJ (DOAJ: Directory of Open Access Journals) (2011)

Silvina Ruvinsky Andrea Lo Monaco Guadalupe Pérez Moira Taicz Laura Inda

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Risk factors for the appearance of secondary foci of infection in children with community-acquired Staphylococcus aureus bacteraemia. Cohort study 2010–2016

Enfermedades infecciosas y microbiologia clinica (English ed ) (2018)

María Guadalupe Juárez Pérez Soledad Martiren Florencia Escarrá Vanesa Reijtman Alejandra Mastroianni

Bacteremia

Blood Culture

10.1016/j.eimce.2017.10.014

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Epidemiología y patrones de sensibilidad a los antimicrobianos de microorganismos aislados de hemocultivos en niños con leucemia aguda

Med. infant (2020)

Marta E. García Reijtman A. Mastroianni Moira Taicz Sonia Gómez

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Características epidemiológicas según el avance de la pandemia SARS-CoV-2 en un hospital pediátrico de alta complejidad en Argentina: estudio descriptivo

Revista chilena de infectología (2021)

Daiana Paola Ferraro Ana Paula Arias Guadalupe Pérez Sandra Gómez Verónica Deschutter

The knowledge of the clinical and evolutionary characteristics of children with SARS-CoV-2 is continuously updated. The true impact of the disease in the pediatric population is still unknown.To describe the clinical characteristics, the use of resources and the evolution of children with COVID-19 in the Garrahan Pediatric Hospital, Buenos Aires, Argentina, in the first 20 weeks from the identification of the first case.Descriptive, analytical, retrospective study. The epidemiological, clinical, evolutionary characteristics and the use of hospital resources of patients < 18 years with confirmed COVID-19 are described. In addition, these characteristics were compared according to whether they occurred in the first 10 epidemiological weeks from the first case of COVID-19 in the hospital or in the following ten weeks.n: 280. The median age was 83 months (IQR 33-144). 209 patients (74.6%) were hospitalized. The median days of hospitalization was 8 days (IQR 3-13). According to the WHO severity classification, there were 184 mild cases (65.7%), 3 moderate (1.1%), 16 severe (5.7%) and 20 critical patients (7.1%). The main reasons for admission to the ICU were not related to SARS-CoV-2 infection. When comparing the characteristics of the patients in the two periods, in the first period there was a higher frequency of underlying comorbidities, immunosuppressive treatment, the consultation was later and the patients had more requirements for ICU admission. Two children (0.7%) died in relation to the infection, both with severe comorbidities and severe bacterial coinfections.In this study, patients with underlying disease predominated. The mild form of the disease was the most frequent presentation. At the beginning of the pandemic, there were more patients under immunosuppressive treatment, the consultation was later and the hospitalization was more frequent, prolonged and with more serious clinical pictures.

Pediatric hospital

10.4067/s0716-10182021000400506

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Risk factors of Viridans Streptococci bloodstream infection in children with Acute leukemia: Case control study.

International Journal of Infectious Diseases (2018)

Moira Taicz Guadalupe Pérez Vanesa Reijtman I. Sormani A. Mastroianni

Mucositis

Bacteremia

10.1016/j.ijid.2018.04.3648

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