A5024130170- Neutropenia and Cancer Infections
- Antifungal resistance and susceptibility
- Pneumonia and Respiratory Infections
- Fungal Infections and Studies
- Bacterial Infections and Vaccines
- Bacterial Identification and Susceptibility Testing
- Hematological disorders and diagnostics
- Blood disorders and treatments
- Pneumocystis jirovecii pneumonia detection and treatment
- Respiratory viral infections research
- Sepsis Diagnosis and Treatment
- Pleural and Pulmonary Diseases
- Nursing care and research
- SARS-CoV-2 and COVID-19 Research
- Streptococcal Infections and Treatments
- Vaccine Coverage and Hesitancy
- Neonatal and Maternal Infections
- Medical research and treatments
- Virology and Viral Diseases
- Neonatal Health and Biochemistry
- Infective Endocarditis Diagnosis and Management
- Childhood Cancer Survivors' Quality of Life
- Public Health and Environmental Issues
- Pharmaceutical studies and practices
- Hematopoietic Stem Cell Transplantation
Hospital Luis Calvo Mackenna
2016-2025
University of Chile
2016-2025
Infant
2024
Hospital for Sick Children
2012-2017
Goethe University Frankfurt
2012-2017
Children's Hospital of Philadelphia
2017
University of Bern
2017
University Children’s Hospital Bern
2017
Government of Catalonia
2015
Faculty (United Kingdom)
2015
Background The epidemiology of candidemia varies depending on the geographic region. Little is known about in Latin America. Methods We conducted a 24-month laboratory-based survey 20 centers seven American countries. Incidence rates were calculated and was characterized. Results Among 672 episodes candidemia, 297 (44.2%) occurred children (23.7% younger than 1 year), 36.2% adults between 19 60 years old 19.6% elderly patients. overall incidence 1.18 cases per 1,000 admissions, varied across...
Purpose To develop an evidence-based guideline for the empiric management of pediatric fever and neutropenia (FN). Methods The International Pediatric Fever Neutropenia Guideline Panel is a multidisciplinary multinational group composed experts in oncology infectious disease as well patient advocate. was convened purpose creating this guideline. We followed previously validated procedures guidelines. Working groups focused on initial presentation, ongoing management, antifungal therapy. Each...
To update a clinical practice guideline (CPG) for the empiric management of fever and neutropenia (FN) in pediatric patients with cancer hematopoietic cell transplantation recipients.The International Pediatric Fever Neutropenia Guideline Panel reconvened to conduct second this CPG. We updated previous systematic review identify new randomized controlled trials (RCTs) evaluating any strategy FN patients. Using Grading Recommendations Assessment, Development Evaluation framework, evidence...
To determine whether Pneumocystis carinii is associated with clinical illness in the competent host, 107 normal, healthy infants were enrolled a 2-year prospective cohort study Chile. P. was identified by specific stains and nested-deoxyribonucleic acid (DNA) amplification of large subunit mitochondrial ribosomal ribonucleic gene f. sp. hominis, seroconversion assessed enzyme-linked immunosorbent assay serum samples drawn every 2 months. DNA nasopharyngeal aspirates obtained during episodes...
PURPOSE: To identify clinical and laboratory parameters present at the time of a first evaluation that could help predict which children with cancer, fever, neutropenia were high risk or low for an invasive bacterial infection. PATIENTS AND METHODS: Over 17-month period, all admitted to five hospitals in Santiago, Chile, enrolled onto prospective protocol. Associations between admission infection assessed by univariate logistic regression analyses. RESULTS: A total 447 febrile neutropenic...
As of September 2022, nearly 1.3 billion doses COVID-19 vaccine products have been administered in Latin America and the Caribbean, where 27% global deaths occurred. This study aimed to estimate effectiveness vaccines against lab-confirmed related hospitalizations among adults Argentina, Brazil, Chile, Colombia.Using a test-negative case control design, we evaluated primary vaccination series considering six (Sputnik V, mRNA-1273, CoronaVac, ChAdOx1, BNT162b2, Ad26.COV2.S) 83,708...
A risk prediction model for invasive bacterial infection (IBI) was prospectively evaluated among children presenting with cancer, fever, and neutropenia. The incorporated assessment of 5 previously identified factors: serum level C-reactive protein (CRP) >/=90 mg/L, hypotension, identification relapse leukemia as the cancer type, platelet count </=50,000 platelets/mm(3), recent receipt chemotherapy [16]. Children were uniformly at enrollment classified having high or low IBI according to a...
We previously demonstrated the immunogenicity and tolerability of serogroup B meningococcal vaccine, 4CMenB (Bexsero®), in 11−17 y-olds randomized to receive 1, 2, or 3 doses at 6 mo intervals. Participants this extension study provided an additional blood sample 18−24 after last vaccine dose, assess persistence serum bactericidal activity with human complement (hSBA), compare age-matched 4CMenB-naïve controls.In original study, one month 93% subjects had seroprotective hSBA titers (≥4)...
To compare outcome and cost of ambulatory versus hospitalized management among febrile neutropenic children at low risk for invasive bacterial infection (IBI).Children presenting with neutropenia six hospitals in Santiago, Chile, were categorized as high or IBI. Low-risk randomly assigned after 24 to 36 hours hospitalization receive treatment monitored until episode resolution. Outcome determined each compared between both groups using predefined definitions questionnaires.A total 161 (41%)...
Background: Active surveillance is necessary for improving the management and outcomes of patients with candidemia. The aim this study was to describe epidemiologic clinical features candidemia in pediatric Latin America. Method: Prospective, multicenter, a population from 23 hospitals 8 America countries between November 2008 October 2010. Results: Three hundred two cases were reported median incidence 0.81/1000 admissions. Eighty nine (29%) neonates. main risk factors prematurity,...
To compare the efficacy of pre-emptive versus empirical antifungal therapy in children with cancer, fever and neutropenia. This was a prospective, multicentre, randomized clinical trial. Children presenting persistent high-risk febrile neutropenia at five hospitals Santiago, Chile, were to or therapy. The group received only if accompanied by clinical, laboratory, imaging microbiological pre-defined criteria. primary endpoint overall mortality day 30 follow-up. Secondary endpoints included...
Respiratory viral infections in episodes of fever and neutropenia (FN) children with cancer are not well characterized. We compared the clinical outcome caused by different respiratory viruses (RVs) RV coinfection this population.Children FN at 3 hospitals Chile were prospectively evaluated examination, blood cultures detection 17 RVs using multiplex polymerase chain reaction (nasopharyngeal samples). Clinical characterization variables determined type detected.A total 1044 525 included. At...
Background Active surveillance is necessary for improving the management and outcome of patients with candidemia. The aim this study was to describe epidemiologic clinical features candidemia in children adults tertiary level hospitals Chile. Methods We conducted a prospective, multicenter, laboratory-based survey 26 care Chile, from January 2013 October 2017. Results A total 780 episodes were included, median incidence 0.47/1,000 admissions. Demographic, microbiological information 384...
During a 2-year period, all children with cancer, neutropenia, and fever who were admitted to Hospital de Niños Luis Calvo Mackenna (Santiago, Chile) enrolled in study of the safety stopping antibiotic therapy on day 3 treatment. Children met predefined criteria for nonbacterial randomized stop (group A) or continue B) therapy. A total 220 cancer had 238 episodes neutropenia; 68 75 entry A, 36; group B, 39). Both groups comparable terms age, gender, oncological disease, chemotherapy status,...
This study compared the antipyretic effectiveness of acetaminophen, ibuprofen, and dipyrone in young children with fever. The results were based on a modified double-blind, randomized, multinational trial that evaluated 628 febrile children, aged 6 months to years. All three drugs lowered temperature 555 patients completing study. Temperature normalization rates ibuprofen groups (78% 82%, respectively) significantly higher than acetaminophen group (68%, P = 0.004). After 4 hours, mean was...
The usefulness of determining serum levels C-reactive protein (CRP) for the identification bacterial infections in febrile neutropenic patients with cancer was evaluated. Two hundred children were monitored prospectively occurrence neutropenia and fever; collected from these baseline CRP. Of 200 children, 75 had 85 episodes; daily CRP analysis by nephelometry. Children included into one three following groups physicians blinded to results analysis: group I, demonstrated infection (24...
Background: Severe sepsis is not clinically apparent during the first 24 hours of hospitalization in most children with cancer and febrile neutropenia (FN), delaying targeted interventions that could impact mortality. The aim this study was to prospectively evaluate biomarkers obtained within as predictors severe before it becomes evident. Methods: Children cancer, admitted FN at high risk for an invasive bacterial infection 6 public hospitals Santiago, Chile, were monitored throughout their...
Background: Early identification of children with cancer at risk for death during a febrile neutropenic (FN) episode may increase their possibility survival. Our aim was to identify the time admission, clinical and laboratory variables differing significantly among who survived or died FN episode. Methods: In prospective, multicenter study, admitted high-risk were uniformly evaluated enrollment managed according national consensus protocol. Medical charts determine whether could be...
Rotavirus and more recently norovirus have been recognized as 2 of the most common causes acute diarrhea in children. Comparative analysis these infections a birth cohort has not performed can provide relevant insight on clinical viral behaviors.Mother-infant pairs from middle-low socioeconomic background living Metropolitan Region Chile are being followed for 18 months outpatient clinics. Infants evaluated monthly asymptomatic excretion rotavirus during episodes (ADE) rotavirus, norovirus,...
Empiric antifungal treatment has become standard of care in children with cancer and prolonged fever febrile neutropenia (FN), the downside that it leads to significant over treatment. We characterized epidemiologic, clinical, laboratory features invasive fungal disease (IFD) FN aim identify risk factors for IFD can aid better selecting who require treatment.In a prospective, multicenter study, admitted at high-risk sepsis, 6 hospitals Santiago, Chile were monitored from admission until end...