The use of sulfomethate sodium colistin for the treatment of infections caused by multiple drug resistant (MDR) Gram-negative microorganisms were studied in a burn unit to evaluate the safety of this drug. A prospective chart review of pediatric patients treated with intravenous colistin in a tertiary burn unit between January 2005 and December 2006 was performed. Forty-five courses of intravenous colistin treatment administered to 45 children were evaluated in the study period. Fourteen patients (31%) were infected by Pseudomonas aeruginosa spp and 20 patients (44.5%) by Acinetobacter spp and an association of both bacteria was found in six patients (13.5%).The mean age of the patients was 52 months (range, 2 to 168 months), and 28 patients (62%) were men. The percentage of burnt body surface was between 9 and 87% (mean, 38%). Forty patients (89%) were infected by MDR organisms. Colistin was empirically indicated in five patients (11%) with burn wound sepsis 7 days after admission to the unit despite negative cultures. Burn wound sepsis was the most frequent focus of infection in 19 patients (42%). In 14 patients (31%), burn wound infection occurred without sepsis. Intravascular catheter-related bacteremia occurred in three patients (7%) and bacteremia in one (2%). Three patients had pneumonia (7%), three osteomyelitis (7%), and two urinary tract infection (4%).The length of treatment with colistin was between 3 and 92 days (median, 21 days). Only one patient (2%) died for reasons other than infection. None of the children developed increases in serum creatinine concentrations or neurological complications during treatment with colistin. Colistin seems to be a safe drug in selected cases of infections with MDR Gram-negative microorganisms. Further studies are needed to confirm these results.

Facebook y Twitter, ¿están ya en el consultorio de los pediatras? Encuesta sobre el uso de las redes sociales Facebook and Twitter, are they already in the pediatrician´s office? Survey on the use of social networks RESUMEN La Web 2.0 ha democratizado el uso de servicios y aplicaciones, siendo Facebook y Twitter sus principales exponentes. Se realizó una encuesta dirigida a profesionales suscriptos a las listas de discusión y visitantes al sitio web de la Sociedad Argentina de Pediatría con el objetivo de conocer el uso de la Web 2.0. Sobre 377 respuestas (76% pediatras), el 81,3% de los usuarios utilizan Facebook y el 16,5% usa Twitter. Los usuarios de Facebook en un 85% lo utilizan para fines personales, mientras que el uso profesional es del 41,2%. Los pediatras usan otras aplicaciones web 2.0 como YouTube (80,3%), compartir imágenes (52,2%) y escuchar Podcasts (34,8%). El 50% mostró interés por recibir información profesional por estos medios. Los médicos deben reconocer estas nuevas herramientas para incorporarlas a la vida profesional. La encuesta nos permitió analizar el uso de estas redes sociales por parte de los pediatras.

In our series Fusarium spp was an uncommon pathogen in severely burnt patients. The burn wound was the most common site of infection and mortality was low.

Background: Multiresistant Acinetobacter spp has emerged as an important microorganisms in critical areas like burn units.Objetives: Infections caused by multiple drug resistant (MDR) Acinetobacter spp was studied in our burn unit to evaluate epidemiological, clinical features, outcome, use of colistin and adverse effects related with this antibiotic.Methods: A prospective chart review of pediatric patients admitted to our tertiary burn unit between January 2005 and December 2006 with isolation of multiresistant Acynetobacter spp was performed. During the study period, 26 p were evaluated with isolation of Acinetobacter spp.Results: The mean age of the patients was 66.5 months (range: 2 to 168 m), 17 patients (65%) were male. The burnt surface was between 10% and 87% (median 42.5%). Full thickness was present in 10 p (39%). Burn wound sepsis was the most frequent focus in 10 patients (39%). In 8 patients (30%), burn wound infection occurred without sepsis. Intravascular catheter-related bacteremia was found in three patients (11%) and bacteremia in one (4%). Two patients had pneumonia (8%), and two urinary tract infection (8%). All patients were treated with colistin.according susceptibility test. The time of colistin treatment was between 10 and 71 days (median 21days). None of the children developed adverse effects attributable to colistin. The outcome was favorable in all patients.Conclusion: Multiresistant Acinetobacter spp has emerged as a new threat in burn units. Burn wound sepsis was the most common foci. Colistin was a safe drug for the treatment. The outcome was favorable in all patients.

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