INTRODUCTION:The mortality rate for dengue shock syndrome (DSS) in the PICU at Children's and Maternity Harapan Kita Hospital is still high (13.2%). OBJECTIVE: We evaluated performance of the Pediatric Logistic Organ Dysfunction (PELOD) score compared with the Pediatric Risk of Mortality III (PRISM III) for predicting mortality in our PICU. METHODS: A total of 42 patients (48% boys, 52% girls) admitted to the PICU from January to December 2006 were enrolled onto the study. Diagnosis of DSS was made according to 1997 World Health Organization criteria and confirmed with serologic-positive dengue blot taken on the fifth day of fever (93% secondary infection and 7% primary infection). PELOD and PRISM scores were evaluated on the first day. RESULTS: From 42 admissions, 1 was excluded for insufficient data. Median age of the children was 7 years. Death occurred in 11.9% of the patients with DSS. Analysis showed that the mean PELOD score was 7.2 (MannWhitney U test between survivors and nonsurvivors was significant at P ϭ .001) compared with the PRISM III (mean score was significant also at P ϭ .008). The receiver operating characteristic curves for the PELOD and PRISM III were 0.954 and 0.868, respectively. CONCLUSIONS: PELOD and PRISM III scores showed a good discrimination for predicting mortality in patients with DSS in our PICU. MIDDLE-EAR FLUID RESULTS:The most common S pneumoniae serotypes isolated were 6B and 19F (16.67% each) and 6A, 14, and 23F (15.27% each). The overall rate of resistance (defined as the rate of intermediate resistance plus the rate of resistance) for penicillin was 65.38% (intermediate and resistant categories were 29.17% and 36.11%, respectively), for cefotaxime was 19.45%, for azithromycin and erythromycin was 23.61%, for trimethoprim/ sulfamethoxazole was 61.11%, for amoxicillin was 5.5%, and for clindamycin was 12.5%. With amoxicillin/clavulanate, ceftriaxone, imipenem, meropenem, teicoplanin, telithromycin, and vancomycin, we found susceptibility for 100% of the isolates. The most common resistant serotypes were 19F and 23F. CONCLUSIONS: The serotype distribution of S pneumoniae that causes pediatric AOM in Mexico is similar to that reported from developed countries. The current heptavalent pneumococcal conjugate vaccine covers 63.89% of AOM episodes in Mexican children.

Invasive pneumococcal disease in a third level pediatric hospital in Mexico City: epidemiology and mortality risk factors.