RESUMENLa pancreatitis aguda es una alteración inflamatoria del páncreas, caracterizada por dolor abdominal y elevación de las enzimas pancreáticas. La pancreatitis aguda necrosante es una complicación grave asociada a altas tasas de morbimortalidad en población adulta; en población pediátrica es una entidad poco frecuente, ocurre en menos del 1 % de los casos. Se ha visto asociada a múltiples etiologías, entre ellos agentes infecciosos como el virus de la Influenza A. En esta oportunidad reportamos un caso de un paciente de 21 meses de edad con virus Influenza A positivo que cursó con pancreatitis aguda.Palabras clave: pancreatitis, pancreatitis aguda necrotizante, Virus de la Influenza A. ABSTRACTThe acute pancreatitis is a sudden inflammation of the pancreas, characterized by abdominal pain and elevations of serum pancreatic enzymes. Necrotizing acute pancreatitis is a significant complication associated with high morbidity and mortality rate in adult population, nevertheless, in pediatric population it is exceptional. This happens in less than 1 % of cases. This has been associated to different etiologies some infectious agents such as A type of influenza virus. In this study we selected a case occurred to a 21 months old patient with type A influenza virus positive, who treated with acute pancreatitis.

Background The epidemiology of methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) S. aureus in pediatrics has changed in recent years. MRSA infections have been reported to be more severe than MSSA. Methods Multicenter retrospective cohort, in 6 pediatric hospitals in Bogotá, Colombia, between January 1, 2014, and December 31, 2018, 1 isolate was included for patient from the same origin. Infections were classified into: SSTI, osteoarticular, bacteremia, or pneumonia.The objective is to establish differences between clinical, laboratory, and outcomes of MSSA and MRSA infections, according to origin of the infection in a pediatric population from Bogotá, Colombia. Results 551 patients were included; 211 (38%) MRSA and 340 (62%) MSSA, in total 703 cultures. Figure 1. Some risk factors were statistically associated with MSSA: Heart disease (3.3% Vs. 0.5%) neurologic disease (5.9% vs. 2.4%), surgery in last 6 months (11% vs. 5%), use of vascular or external devices (3% vs 11%) and previous hospitalization >3 days (11% vs 17%) Table 2. In 84/159 (52%) cases, bacteremia was associated with osteoarticular infection (OI), 19/159 (13%) with pneumonia, 21/159 (13%) with SSTI, 14/159 (9%) with other foci, 21/159 (13%) were primary. Independently of the origin, PICU admittance was more frequent in MRSA (52% vs. 28), as well as mechanical ventilation (MV) (30% vs. 13%) and inotropic support (IS )(38% vs 17%). Of 136 osteoarticular infections, 59 (43,4%) were MRSA and 77 (56,6%) MSSA. MRSA isolates required more than 3 surgical procedures (45% vs 24%), more PICU admittance (36% vs. 12%) and IS (27% vs. 5%). Complicated pneumonia was more frequently associated to MRSA in comparison with MSSA (57% vs. 23%). In pneumonia, MRSA also was significantly associated with PICU. (74%vs 50%), MS (61%vs 32%), and VS (52% vs 27%). SSTI was not associated with greater severity or worse outcome (PICU, MV, IS) according to S. aureus susceptibility. Table 3b. Infection groups depending on the presence or not of resistance Conclusion MRSA was associated with more severe course in bacteremia, OI and pneumonia. It is interesting that some classically risk factors associated with MRSA infections were found to be related to MSSA. In general, with SSTI exception, MRSA increase risk of PICU, mechanical support and inotropic support in a pediatric population in Bogotá, Colombia. Disclosures Ivan Felipe Gutiérrez Tobar, n/a, Pfizer and MSD (Advisor or Review Panel member, Research Grant or Support, Speaker’s Bureau, Has received support from Pfizer and MSD for participation in congresses and has received conference payments from Pfizer)Pfizer and MSD (Speaker’s Bureau, Other Financial or Material Support, Has received support from Pfizer for participation in congresses) Sandra Beltran, n/a, Pfizer (Other Financial or Material Support, Has received support from Pfizer for participation in congresses)