Boletín médico del Hospital Infantil de México最新文献

{"title":"Cross-sectional and longitudinal relationships between abdominal fat depots and cardiometabolic risk in a sample of Mexican adolescents.","authors":"Luis Ortíz-Hernández, Erica G Soltero, Miguel Camejo, Jesús Valdes","doi":"10.24875/BMHIM.25000061","DOIUrl":"10.24875/BMHIM.25000061","url":null,"abstract":"<p><strong>Background: </strong>The relationship between abdominal fat depots and cardiometabolic risk among youth is inconclusive due to the cross-sectional nature of existing studies and limitations in assessment methods. In this study, we examined cross-sectional and longitudinal associations of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) with cardiometabolic risk indicators among Mexican adolescents.</p><p><strong>Methods: </strong>Participants (n = 169 at baseline and 134 at follow-up) were assessed for diastolic or systolic blood pressure (DBP or SBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, glucose, and insulin. VAT and SAT were measured using magnetic resonance imaging. Measures were repeated at 1-year follow-up. Using multilevel linear regression models, the associations among fat depots and cardiometabolic risk indicators were examined.</p><p><strong>Results: </strong>At baseline, SAT measures were cross-sectional and positively associated with glucose, insulin, TC, triglycerides, SBP, and BDP in boys, and DBP in girls, but negatively with HDL-C. VAT measures were cross-sectional and positively associated with glucose, insulin, and SBP and DBP in boys. VAT at L1-L2 was longitudinal and positively associated with insulin, TC, LDL-C, and DBP in boys.</p><p><strong>Conclusions: </strong>Higher levels of SAT and increases in VAT during adolescence may be particularly detrimental to cardiometabolic health, contributing to an increased risk of future diseases. Future intervention and treatment strategies should target VAT to reduce disease risk in this population.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"83 1","pages":"21-31"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147302368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial stewardship in pediatrics: use of antibiotics in hospitalized pediatric patients in Peru.","authors":"Medalit Luna-Vílchez, Mitsi S Abal, Graciela Taipe-Sedano, Pool Flores-Choque, Eduardo Siesquén, José López, Jorge Osada","doi":"10.24875/BMHIM.25000064","DOIUrl":"https://doi.org/10.24875/BMHIM.25000064","url":null,"abstract":"<p><strong>Background: </strong>The inappropriate use of antibiotics leads to a range of clinical and administrative problems. Understanding antibiotic use in different contexts is therefore essential. This study aims to describe antibiotic use among hospitalized patients in a specialized pediatric center in Peru.</p><p><strong>Methods: </strong>This was a descriptive cross-sectional study. Data were collected using the WHO methodology for point prevalence surveys of antimicrobial use. All patients hospitalized during November 2023 were included. Demographic data, antibiotic use, and types of infections were recorded.</p><p><strong>Results: </strong>A total of 252 patients were evaluated, of whom 127 (50.4%) received 186 antibiotic treatments. Most patients (58.7%) received only one antibiotic prescription. Most infections treated were healthcare-associated infections, with empirical treatment initiated based on a diagnosis of clinical sepsis. The most used antibiotics were vancomycin (21.5%), meropenem (15.6%), and piperacillin/tazobactam (10.8%). Most antibiotics were prescribed empirically at the discretion of the treating physician.</p><p><strong>Conclusions: </strong>Ongoing evaluation of antibiotic use patterns is essential to develop targeted interventions aimed at improving infection control and reducing antimicrobial resistance.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"83 3","pages":"178-187"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Position statement of the Mexican Academy of Pediatrics regarding strategies to prevent respiratory syncytial virus infection in Mexico's pediatric population.","authors":"Rosa M Wong-Chew, María Del C Espinosa-Sotero, Ana E Limón-Rojas, María G Miranda-Novales, Martha J Avilés-Robles, José I Castillo-Bejarano, Sarbelio Moreno-Espinosa, Rodrigo Romero-Feregrino, Socorro A Anzures-Gutiérrez, Fortino Solórzano-Santos, Antonio Luévanos-Velázquez, Patricia Saltigeral-Simental, Mónica Reyes-Berlanga, Claudia Del C López-Enríquez, Denisse Vaquera-Aparicio, Mariana Merlo-Palomera, Leticia Belmont-Martínez","doi":"10.24875/BMHIM.26000053","DOIUrl":"10.24875/BMHIM.26000053","url":null,"abstract":"&lt;p&gt;&lt;p&gt;El virus sincicial respiratorio (VSR) constituye una de las principales causas de infección respiratoria aguda baja, bronquiolitis, neumonía y hospitalización en niños, con mayor riesgo de gravedad en menores de seis meses, prematuros, pacientes con displasia broncopulmonar, cardiopatías congénitas, inmunocompromiso y otras comorbilidades. En México, la evidencia disponible muestra una carga clínica relevante y una estacionalidad predominante de septiembre a marzo. El desarrollo de nuevas estrategias preventivas ha transformado el abordaje del VSR, particularmente mediante la vacunación materna con vacuna bivalente de proteína F prefusión y la inmunoprofilaxis pasiva con anticuerpos monoclonales de acción prolongada. El presente posicionamiento de la Academia Mexicana de Pediatría revisa la evidencia epidemiológica, clínica y de efectividad en vida real sobre las estrategias disponibles para la prevención de la enfermedad por VSR en población pediátrica. La vacunación materna entre las 32 y 36 semanas de gestación permite la transferencia transplacentaria de anticuerpos y confiere protección al lactante durante los primeros meses de vida. Por su parte, los anticuerpos monoclonales, especialmente el nirsevimab, han demostrado reducciones significativas en infección respiratoria baja, hospitalización, ingreso a cuidados intensivos y enfermedad grave asociada a VSR, con un perfil de seguridad favorable. Con base en la carga de enfermedad, la estacionalidad nacional, la disponibilidad de productos preventivos y las condiciones del sistema de salud mexicano, la Academia Mexicana de Pediatría propone una estrategia complementaria y progresiva que integre vacunación materna e inmunoprofilaxis con anticuerpos monoclonales, priorizando inicialmente a lactantes de alto riesgo y ampliando de manera gradual la cobertura hacia todos los lactantes susceptibles.&lt;/p&gt;&lt;p&gt;&lt;p&gt;Respiratory syncytial virus (RSV) is one of the leading causes of acute lower respiratory tract infection, bronchiolitis, pneumonia, and hospitalization among infants and young children, with the highest risk of severe disease observed in infants younger than six months, preterm infants, and children with bronchopulmonary dysplasia, congenital heart disease, immunocompromising conditions, and other underlying comorbidities. In Mexico, available evidence demonstrates a substantial clinical burden and a predominant seasonal circulation from September to March. In recent years, the development of novel preventive strategies has transformed the approach to RSV prevention, particularly through maternal immunization with a bivalent prefusion F protein vaccine and passive immunoprophylaxis with long-acting monoclonal antibodies. This position statement from the Mexican Academy of Pediatrics reviews the epidemiological, clinical, and real-world effectiveness evidence regarding currently available strategies for the prevention of RSV infection in the pediatric population. Maternal vaccination betw","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"83 4","pages":"217-231"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten specific updates for the Mexican atopic dermatitis guidelines, GUIDAMEX 1.1.","authors":"Désirée E Larenas-Linnemann, Helena Vidaurri-de la Cruz, Catalina Rincón-Pérez, Jorge A Luna-Pech, Alejandra Macías-Weinmann, Elsy M Navarrete-Rodríguez, Blanca E Del-Río-Navarro, Liliana Godínez-Aldrete, Esther Guevara-Sanginés, Mirna E Toledo-Bahena, Adriana M Valencia Herrera","doi":"10.24875/BMHIM.26000025","DOIUrl":"10.24875/BMHIM.26000025","url":null,"abstract":"&lt;p&gt;&lt;p&gt;En 2022 se desarrolló la guía de dermatitis atópica (DA) para México (GUIDAMEX-2022) con metodología ADAPTE. El objetivo del grupo de desarrollo de la guía es generar GUIDAMEX 1.1 con actualizaciones puntuales. Ante nuevas aprobaciones globales, formulamos 10 preguntas clínicas clave y, con evidencia de guías internacionales actualizadas, costos, seguridad y contexto mexicano, emitimos recomendaciones (R) y sugerencias (S) y puntos de buena práctica para orientar práctica clínica nacional. Así, GUIDAMEX 1.1 hace una sugerencia condicional para considerar como objetivo de tratamiento para DA medidas de prevención terciaria (priorizando evitar desarrollo de comorbilidades alérgicas). Existe evidencia limitada para inmunoterapia específica de alérgeno y cuestionada para dupilumab. También sugiere contemplar la actividad mínima de la enfermedad con EASI-90/100 y metas de tratamiento formulados por el paciente. Se agregan a las indicaciones de GUIDAMEX-2022 otros medicamentos con recomendación (R) o sugerencia (S). Tratamiento tópico: crisaborol (R, aprobado en México para ≥ 3 meses), y tapinarof, ruxolitinib y roflumilast (S) con aprobaciones por agencias internacionales (FDA o EMA). Tratamiento sistémico: dupilumab (R, ≥ 6 meses), baricitinib (S, ≥ 2 años), lebrikizumab y nemolizumab (S, ≥ 12 años); y aprobado por la FDA o la EMA, el tralokinumab (S). En conclusión los avances en DA permiten metas ambiciosas; GUIDAMEX actualizado brinda en México indicaciones y posología de tratamientos vigentes.&lt;/p&gt;&lt;p&gt;&lt;p&gt;The atopic dermatitis (AD) guideline for Mexico (GUIDAMEX-2022) was developed using the ADAPTE methodology. The objective of the guideline development groups was to generate GUIDAMEX 1.1 with timely updates. In response to new global approvals, we formulated 10 key clinical questions and, based on evidence from updated international guidelines, costs, safety, and the Mexican context, we issued recommendations (R) and suggestions (S) and good practice points to guide national AD management. GUIDAMEX 1.1 makes a conditional suggestion to consider tertiary prevention measures as a treatment objective (prioritizing the prevention of allergic comorbidities). There is some evidence for dupilumab and allergen-specific immunotherapy, but it is limited. We also suggest considering minimal disease activity with EASI-90/100 and patient-defined treatment goals. Additional medications with recommendation (R) or suggestion (S) are added to the GUIDAMEX-2022 indications. Topical management: crisaborole (R, approved in Mexico for ≥ 3 months); and tapinarof, ruxolitinib, and roflumilast (S) with approvals from international agencies (FDA or EMA). Systemic management: dupilumab (R, ≥ 6 months), baricitinib (S, ≥ 2 years), lebrikizumab and nemolizumab (S, ≥ 12 years); and FDA or EMA-approved, tralokinumab (S). Thus, advances in atopic dermatitis allow for ambitious clinical goals. The ongoing update of GUIDAMEX offers prescribers in Mexico the latest indication","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"83 Supl 1","pages":"1-23"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution of childhood cancer types using the International Classification of Childhood Cancer, third edition classification in a tertiary hospital in northwest Mexico.","authors":"Francisco J García-Alvarado, César M Lozano-Escárcega, Enrique E López-Facio, Argelia Silva -Alemán, Fany K Segura-López, Melisa A Muñoz-Hernández","doi":"10.24875/BMHIM.25000049","DOIUrl":"10.24875/BMHIM.25000049","url":null,"abstract":"<p><strong>Background: </strong>In Mexico, childhood cancer is the leading cause of death by disease in children between 5 and 14 years of age, and the sixth leading cause of death in children under 5 years of age. In addition, it represents almost 70% of the total cancer burden in the pediatric population. It comprises a heterogeneous group of malignancies with different clinical patterns, etiologies, therapeutic options, and survival prognoses.</p><p><strong>Methods: </strong>Descriptive cross-sectional study that included confirmed cases of childhood cancer in patients between 1 and 18 years of age, diagnosed with hematolymphoid neoplasms and solid tumors. The study was carried out in a third-level hospital of the Instituto Mexicano del Seguro Social UMAE N71, located in northwest Mexico, during the year 2024. The International Classification of Childhood Cancer, third edition (ICCC-3), was used for the analysis and classification of cases.</p><p><strong>Results: </strong>The mean age of the patients was 8 years, with a distribution of 40.4% in females and 59.5% in males. Leukemia was the most common pediatric cancer, with acute lymphoblastic leukemia standing out in 45% of cases. This was followed by solid tumors in the central nervous system (CNS), representing 20.2%, the most frequent being astrocytomas, ependymomas, and other types of gliomas.</p><p><strong>Conclusions: </strong>Leukemias and CNS tumors were identified as the most frequent types of childhood cancer in the northwestern region of Mexico. The use of the classification (ICCC-3) represents a fundamental tool for the standardization of diagnosis and epidemiological analysis of childhood cancer.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"83 1","pages":"14-20"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147302291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal mass secondary to fetus-in-fetu in a neonate: case report and literature review.","authors":"Yaradith Urueña-Prado, Juan J Piña Perales, Jesús E Vargas-Alvarez, Ma Fernanda Zapata-de la Rosa, Rigoberto Martínez-Parroquín, Eladio Fuentes-Soto","doi":"10.24875/BMHIM.25000016","DOIUrl":"10.24875/BMHIM.25000016","url":null,"abstract":"<p><strong>Background: </strong>Among the various etiologies related to the presence of abdominal masses in newborns, the diagnosis of fetus in fetu (FIF), a term used to describe a congenital condition in which one fetus parasitizes the body, should be considered.</p><p><strong>Clinical case: </strong>We present the case of a male newborn who was found to have an abdominal mass during perinatal evaluation, leading to termination of pregnancy by cesarean section. After a thorough evaluation, a protocol was established that resulted in surgical intervention and the diagnosis of FIF.</p><p><strong>Conclusions: </strong>FIF is an exceptionally rare entity characterized by the presence of a \"parasitic twin.\" Its pathophysiology and risk factors remain poorly understood, but it must be considered in the differential diagnosis of neonatal abdominal masses. Owing to its rarity, standardized follow-up protocols have not been established. Nevertheless, with current advances in pediatric surgery, the prognosis after complete excision is favorable.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"83 1","pages":"62-67"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147302326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in lactation: exploring the role of human breast milk microbiota in neonatal gut maturation.","authors":"Azucena Ocampo-Bárcenas, Marlon De Ita, José M Figueroa-Torres, Angélica Ma López-Rodríguez, Estela Ruíz-Baca, Iván Meneses-Morales","doi":"10.24875/BMHIM.25000078","DOIUrl":"10.24875/BMHIM.25000078","url":null,"abstract":"<p><p>The neonatal microbiota plays a central role in shaping gastrointestinal and immune system maturation, laying the foundation for lifelong health. Prenatally, bacteria in the amniotic fluid and meconium, likely derived from the maternal microbiota, prime the fetal immune system to tolerate beneficial microbes postnatally. At birth, the neonate acquires its initial microbiota through the birth canal or environmental exposure, with breast milk delivering human milk oligosaccharides that selectively nourish beneficial bacteria, such as Lactobacillus and Bifidobacterium, fostering a protective gut microbiota. Meconium in the colon further supports this process by acting as a barrier against pathogens while promoting colonization by commensal microbes. These early microbial communities enhance intestinal barrier function through tight junction maturation, reduce permeability, and bolster immune defenses, mitigating infection risks. As infants transition to solid foods, microbial diversity increases, supporting intestinal villi development, nutrient absorption, and dietary adaptability. By approximately 3 years of age, the gut microbiota stabilizes, driving critical roles in digestion, vitamin synthesis, and inflammation regulation. This review synthesizes current evidence on the dynamic interaction and influence of maternal factors and breast milk composition on neonatal microbiota development, highlighting current insights into their implications for the infant's immune system and gastrointestinal development.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"83 1","pages":"3-13"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147302354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges of criticism in dark times: evolution of a thought.","authors":"Leonardo E Viniegra-Velázquez","doi":"10.24875/BMHIM.25000160","DOIUrl":"10.24875/BMHIM.25000160","url":null,"abstract":"<p><p>This essay synthesizes various articles and books published over five decades, a lapse in which the characteristics and attributes of what we now call genuine criticism were specified, which was the result of exerting it in questioning prevailing ideas and theories in different fields such as education in general, medical education, health research or human progress. With regard to the \"dark times\" of the title, they refer to our \"diagnosis\" of the current situation of the dominant western civilization, which we have characterized for a decade: \"The human world immersed in unprecedented absolute degradation, is evidence of the exhaustion and civilizational ruin of the dominant culture that, under the relentless dominant interests of profit, has made the most sublime and despicable commodity of the human condition, and the worst atrocities and planetary devastation profitable.\" As for the subtitle, an update is presented to the proposals developed in the criticism of the above-mentioned fields, condensed in four tables explaining them: the way of criticism and its vicissitudes; techno-phetishism, a particular expression of civilizational collapse; attributes of criticism, and the reasons of being critical thought, in times that run.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"83 3","pages":"151-160"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familial intrahepatic cholestasis: consensus recommendations for healthcare professionals in Latin America.","authors":"Gilda Porta, Gustavo Boldrini, Verónica Botero, Alejandra Consuelo-Sánchez, Janetliz Cucho Jurado, Elisa De Carvalho, Ma Paz Muñoz, Carol Lezama-Elacharri, Irene Kazue-Miura, Felipe Ordoñez","doi":"10.24875/BMHIM.25000067","DOIUrl":"10.24875/BMHIM.25000067","url":null,"abstract":"<p><strong>Background: </strong>Progressive familial intrahepatic cholestasis (PFIC) is rare genetic liver disorders that often present with early-onset cholestasis, pruritus, and potential progression to severe liver complications. This article outlines consensus recommendations for the diagnosis and management of PFIC tailored to Latin American healthcare providers.</p><p><strong>Methods: </strong>A working group of 10 hepatologists across Latin America utilized the Population, Intervention, Comparison, and Outcome (P.I.C.O.) framework to address critical clinical questions related to PFIC's epidemiology, diagnosis, and treatment. A systematic literature review was conducted to understand the disease's heterogeneous nature and its impact on patients' quality of life.</p><p><strong>Results: </strong>The consensus emphasizes early referral to specialists, the importance of genetic testing for definitive diagnosis, and individualized treatment approaches with medical therapies including ursodeoxycholic acid and novel ileal bile acid transport inhibitors. Surgical options, including liver transplantation, should be considered based on disease sub-types. The article also highlights challenges unique to Latin America, such as limited access to specialized care and genetic testing.</p><p><strong>Conclusions: </strong>Early diagnosis and a comprehensive, individualized management plan are essential for improving outcomes in PFIC patients. This consensus aims to increase awareness and understanding of PFIC among healthcare providers.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"83 1","pages":"32-44"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147302311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized controlled, double blind trial of use of vancomycin catheter-lock to prevent Gram-positive bloodstream infection in neonates.","authors":"Carlos López-Candiani, Silvestre García-de la Puente, José L Arredondo-García","doi":"10.24875/BMHIM.25000116","DOIUrl":"10.24875/BMHIM.25000116","url":null,"abstract":"<p><strong>Background: </strong>Central lines are more frequently used in infant newborns; they offer advantages but are related to traumatic complications, obstruction and infection. Antibiotics in catheter locks may decrease infections. The aim of this work was to evaluate the efficacy of vancomycin catheter lock to prevent Gram-positive bloodstream infection.</p><p><strong>Methods: </strong>Randomized controlled doubled blind trial in newborn with central catheter in first 48 hours. Parents informed consent was obtained. Two groups were formed: experimental group with vancomycin catheter lock twice a day for 30 minutes and control group with normal saline solution catheter lock. Primary outcome was Gram-positive bacterial bloodstream infection. Trial was approved by the project review committees of the National Institute of Pediatrics.</p><p><strong>Results: </strong>Sixty-one patients were included, with mean gestational age of 34.9 weeks of gestation and 2,044 g of weight. Mean stay of catheter was 14.6 days and parenteral nutrition 12 days. It was lower suspicion of sepsis in experimental group (25 vs. 34.5%), fewer bloodstream infections (3.1 vs. 13.8%) and lower infection density per 1,000 catheter/days (2.3 vs. 4.6), but none of these were statistically significative.</p><p><strong>Conclusions: </strong>Vancomycin catheter-lock diminished bloodstream infections at 25% respect control group and 50% density infection per 1000 catheter/days, without being statistically significant.</p>","PeriodicalId":9103,"journal":{"name":"Boletín médico del Hospital Infantil de México","volume":"83 3","pages":"170-177"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}