Resumen OBJETIVO: Determinar los gérmenes más frecuentes causantes de infecciones en recién nacidos hospitalizados y la susceptibilidad antimicrobiana. MATERIAL Y MÉTODOS: Revisión de historias clínicas del Servicio de Neonatología del Instituto de Salud del Niño (Lima, Perú) y resultados de cultivos positivos y antibiogramas, desde junio de 1999 hasta mayo de 2002. RESULTADOS: Durante el periodo de estudio hubo 94 pacientes con sepsis confirmada; de ellos se obtuvo 161 muestras (sangre, orina, catéteres EV, entre otras). Los gérmenes más frecuentes fueron: Staphylococcus epidermidis (38,3%), Staphylococcus aureus (12%), Klebsiella sp (10%), Alcaligenes fecalis (4,6%), Acinetobacter sp (4%) y Pseudomonas aeruginosa (4%). S. epidermidis mostró sensibilidad de 100% a vancomicina, 90% a cefotaxima, 50% a amikacina y ampicilina y 37% a oxacilina. Klebsiella mostró sensibilidad de 100% a ciprofloxacina e imipenen, 44% a ceftriaxona, 20% a ceftazidima y 14% a ampicilina; la resistencia a amikacina fue del 100%. S. aureus mostró sensibilidad de 100% a vancomicina, 57% a cefotaxima y 33% a oxacilina. CONCLUSIONES: Las bacterias gram positivas son las más frecuentes como causa de sepsis neonatal. In vitro, los gérmenes más frecuentes muestran resistencia mayor de 50% a ampicilina y amikacina; y vancomicina es el antibiótico al cual muestran mayor susceptibilidad las especies de During this three year period there were 94 patients with confirmed sepsis from whom 161 samples were obtained (blood, urine, IV catheters, and others ). The most frequently isolated bacteria were: Staphylococcus epidermidis (38,3%), Staphylococcus aureus (12%), Klebsiella sp (10%), Alcaligenes fecalis (4,6%), Acinetobacter sp (4%) and Pseudomonas aeruginosa (4%). S. epidermidis showed 100% sensitivity to vancomycin, 90% to cefotaxime, 50% to amikacin and ampicillin and 37% to oxacillin. Klebsiella showed 100% sensitivity to ciprofloxacin and imipenem, 44% to ceftriaxone, 20% to ceftazidime and 14% to ampicillin; bacterial resistance to amikacin was 100%. S. aureus showed 100% sensitivity to vancomycin, 57% to cefotaxime and 33% to oxacillin. CONCLUSIONS: Gram positive bacteria are the most frequent cause of neonatal sepsis. In vitro, 50% of the most frequent bacteria showed resistance to ampicillin and amikacin. The Staphylococcus species showed greater in vitro sensitivity to vancomycin.

The double burden of malnutrition is the coexistence of two different conditions, mainly reflected as excess or deficit in weight. Anemia is a specific nutritional deficit not always included in the double burden assessment. We reviewed overweight and/or obesity (OW/OB) and anemia studies from Latin-American Children over the last ten years up to 2019. Two authors evaluated the MEDLINE, SCOPUS, and LILACS databases. A scale of ten questions was used to assess the risk of bias in prevalence studies. Fourteen studies were selected. The population studies' size ranged from 147 to 20,342 children with different socioeconomic backgrounds, such as urban, peri-urban and rural settings, socioeconomic status, schooling, population (ethnic minorities and indigenous), and environmental differences (sea level or high altitude). The prevalence of OW/OB ranged from 4.9% to 42%. The prevalence of anemia was from 3.4% to 67%. The double burden, including OW/OB and anemia, ranged from 0.7% to 67%. A higher prevalence of excess weight and anemia was found in rural and high altitude above sea level environments, extreme poverty, low education level, and indigenous communities. These heterogeneous data, before the 2020 (COVID-19 pandemic), reflect the vast inequities between countries and within each country. Food insecurity linked to poverty and the induced change in eating habits and lifestyles threaten optimal child nutrition in ongoing and future scenarios. The existence of OW/OB and anemia and their simultaneous coexistence in the community, home, and individual levels, indicates that interventions should be comprehensive to face the double burden of malnutrition.

Continuous training and certification in Abstract: About 10% of all newborns may have difficulty breathing and Background require support by trained personnel. In Peru, 90% of deliveries occur in health facilities. However, there is not a national neonatal resuscitation and certification program for the public health sector. In addition, the Andes and the Amazon regions concentrate large rural remote areas, which further limit the implementation of training programs and the accomplishment of continuous certification. Neonatal resuscitation training through the use of information, communication and technology (ICT) tools running on computers, tablets or mobile phones, may overcome such limitations. This strategy allows online and offline access to educational resources, paving the way to more frequent and efficient training and certification processes.: To evaluate the effects of a neonatal resuscitation training and Objective certification program that uses a multi-platform ICT (MP-ICT) strategy on neonatal health care in remote areas.: We propose to conduct the study through a cluster-randomized trial, Methods where the study and analysis unit is the health care facility. Eligible facilities will include primary and secondary health care level facilities that are located in provinces with neonatal mortality rates higher than 15 per 1,000 live births. We will compare the proportion of newborns with a heart rate ≥100 beats per minute at two minutes after birth in health care facilities that receive MP-ICT training and certification implementation, with those that receive standard training and certification.: We expect that the intervention will be shown as more effective Discussion

Objetivos: Determinar el efecto de una exposición de dos horas de hiperoxia al 21%, 40% y 100% sobre la morfología cerebral, en unmodelo experimental de asfixia neonatal. Diseño: Estudio experimental. Institución: Instituto Nacional de Salud del Niño, Lima, Perú.Material biológico: Ratas albinas Holtzmann. Intervenciones: Ciento veinte ratas albinas Holtzmann de una semana de nacidas (aexcepción del grupo control) fueron sometidas a asfixia experimental por ligadura de la arteria carótida izquierda y luego expuestasa hipoxia (oxígeno al 8%). Después fueron asignadas aleatoriamente a uno de los siguientes grupos: exposición por dos horas a O2al 100%, a O2 al 40%, a O2 al 21% y un grupo control (no expuesto a asfixia experimental). El daño cerebral fue evaluado mediantela medición del peso cerebral y el porcentaje del área cerebral con daño microscópico. Principales medidas de resultados: Dañocerebral. Resultados: El peso cerebral promedio fue menor en los animales de los grupos sometidos a hiperoxia experimental (ANOVA;p<0,001). Se presentó daño cerebral microscópico con mayor frecuencia en el grupo sometido a hipoxia experimental que recibióO2 100% por dos horas y con menor frecuencia en el que recibió O2 al 40% (60% versus 43,3%), diferencia que fue estadísticamentesignificativa (prueba χ2; p<0,001). El grupo sometido a hipoxia experimental que recibió O2 100% tuvo un mayor porcentaje promediode área cerebral con daño microscópico (18,3%), en comparación con los otros grupos de hipoxia experimental, aunque la diferenciano fue estadísticamente significativa (ANOVA; p=0,123). Conclusiones: La hiperoxia al 100% por dos horas se asoció con menor pesocerebral y mayor daño cerebral en animales de experimentación sometidos a asfixia neonatal experimental.

Continuous training and certification in neonatal resuscitation Abstract: About 10% of all newborns may have difficulty breathing and Background require support by trained personnel. In Peru, 90% of deliveries occur in health facilities. However, there is not a national neonatal resuscitation and certification program for the public health sector. In addition, the Andes and the Amazon regions concentrate large rural remote areas, which further limit the implementation of training programs and the accomplishment of continuous certification. Neonatal resuscitation training through the use of Information, Communication and Technology (ICT) tools, running on computers, tablets or mobile phones, may overcome such limitations. This strategy allows online and offline access to educational resources, paving the way to more frequent and efficient training, and certification processes.: To evaluate the effects of a neonatal resuscitation training and Objective certification program that uses a Multi-Platform ICT (MP-ICT) strategy on neonatal health care in remote areas.: We propose to conduct the study through a cluster-randomized trial, Methods where the study and analysis unit is the health care facility. Eligible facilities will include primary and secondary health care level facilities that are located in provinces with neonatal mortality rates higher than 15 per 1,000 live births. We will compare the proportion of newborns with a heart rate ≥100 beats per minute at two minutes after birth in health care facilities that receive MP-ICT training and certification implementation, with those that receive standard training and certification.: We expect that the intervention will be shown as more effective Discussion