El SARS-CoV-2 pertenece a la familia de los β-coronavirus, los cuales son virus de ácido ribonucleico (ARN) de cadena simple, polaridad positiva, envueltos, no segmentados, con genoma de 27 a 32 kb y tamaño de 80-160 nm. Son los virus de ARN más grandes hasta ahora descubiertos y pertenecen al grupo IV de la clasificación de Baltimore. 1 Se conocen hasta ahora cuatro géneros y se distinguen por el huésped al que infectan: α-coronavirus: mamíferos, β-coronavirus (subdivididos en los grupos AD): mamíferos, γ-coronavirus: aves, peces, y por último δ-coronavirus: aves. 2 En la actualidad, existen siete coronavirus que infectan al humano 1 (Tabla 1). Los tres coronavirus que afectan al humano y que tienen elevada patogenicidad son: síndrome Respiratorio Agudo Grave-1 (SARS-CoV-1), síndrome respiratorio de Oriente Medio (MERS-CoV) y síndrome Respiratorio Agudo Grave-2 (SARS-CoV-2), los cuales se han caracterizado por asociarse a enfermedad grave. 2 En la Tabla 2 se describe la fecha, origen, tipo de receptor, enfermedad causada, número de países afectados, total de casos confirmados, defunciones y número de reproducción básica (R0) hasta el día 8 de Características del SARS-CoV-2 y sus mecanismos de transmisión SARS-CoV-2; Virus characteristics and transmission

Mendelian susceptibility to mycobacterial disease (MSMD) is a rare genetic disorder characterized by impaired immunity against intracellular pathogens, such as mycobacteria, attenuated Mycobacterium bovis -Bacillus Calmette–Guérin (BCG) vaccine strains, and environmental mycobacteria in otherwise healthy individuals. Retrospective study reviewed the clinical, immunological, and genetic characteristics of patients with MSMD in Mexico. Overall, 22 patients diagnosed with MSMD from 2006 to 2021 were enrolled: 14 males (64%) and eight females. After BCG vaccination, 12 patients (70%) developed BCG infection. Furthermore, 6 (22%) patients developed bacterial infections mainly caused by Salmonella , as what is described next in the text is fungal infections, particularly Histoplasma. Seven patients died of disseminated BCG disease. Thirteen different pathogenic variants were identified in IL12RB1 ( n = 13), IFNGR1 ( n = 3), and IFNGR2 ( n = 1) genes. Interleukin-12Rβ1 deficiency is the leading cause of MSMD in our cohort. Morbidity and mortality were primarily due to BCG infection. Supplementary Information The online version contains supplementary material available at 10.1007/s10875-022-01357-8.

Tratamiento con linezolid intraventricular más intravenoso en un paciente pediátrico con ventriculitis por Enterococcus faecium resistente a vancomicina Treatment with intraventricular linezolid plus intravenous in a pediatric patient with vancomycin-resistant Enterococcus faecium ventriculitis

Background Osteoarticular infections are serious invasive pathologies in the pediatric population. They have high morbidity, especially if antimicrobial treatment is inadequate and late. Based on pediatric series patients with osteomyelitis require prolonged antibiotic schemes, long stay and high hospital costs, multiple surgical procedures and develop short and long-term sequelae. Methods A retrospective, observational, longitudinal and analytical study was conducted in patients under 17 years of age diagnosed with osteomyelitis at the National Institute of Pediatrics from January 2009 to January 2019. Demographic information, clinical presentation, microbiological, treatment and six-month follow-up were recorded. Results A total of 109 patients were included, 57 (52%) males with median age of 98 (1-205) months with predominance in previous healthy (66%). By temporality, the chronic form predominated in 72%. The history of trauma was identified in 26% and fracture 19%. The most affected bone was femur 26%. Blood culture was performed in 55%, secretion culture in 52.2% with isolation in 56%. Methicillin-susceptible Staphylococcus aureus (MSSA) was the main agent identified. Complications occurred in 37%, the most frequent was surgical wound infection in 13% followed by fracture 11%. Risk factors for complications were chronic osteomyelitis RR 5.7 (CI 1.8-17.9), Sepsis/Shock RR 3.8 (CI 1.08-13-8) and MSSA infections RR 2.7 (CI 1.01-7.5); Risk factors for surgical site infection included initial fracture RR 3.5 (CI 1-11), local ulcer RR 4.2 (CI 1.3-13.06) and MSSA infection RR 5.9 (CI 1.8-19.4). Risk factors for limitation to movement included chronic osteomyelitis RR 4.87 (CI 1.6-14), fever RR 2.5 (CI 1.15-5.5), Sepsis/shock RR 5.3 (CI 1.3-20) (p 0.013) and MSSA infection RR 4.1 (CI 1.4-11.9). Conclusion Osteomyelitis is still a health problem in our country. The diagnosis of osteomyelitis may be challenging as lack of suspicion often leads to delayed diagnosis. Knowledge of the risk factors for complications in pediatric patients could be useful to give early and proper antibiotic and surgical treatment. It is a priority to have a multidisciplinary team for the diagnosis and treatment of osteoarticular infections. Disclosures All Authors: No reported disclosures

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