Browsing by Autor "Raúl Copana-Olmos"

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An Outbreak Of Ralstonia Insidiosa In Hospitalized Children
(2024) Raúl Copana-Olmos; Maria Elena Calderon-Lopez; Roxana Ramos-Cardenas; Wara Ledezma-Hurtado; Hirma Calle-Cruz; Fatima Cano-Guzman
<title>Abstract</title> Introduction: Healthcare-associated infections are a public health problem, resulting in increased morbidity, mortality and costs to patients. The present study aims to analyze an in-hospital outbreak of <italic>Ralstonia insidiosa</italic> in children admitted to a pediatric referral hospital, with a focus on the control and prevention measures implemented. Methodology: An observational prospective study was conducted from the beginning of an outbreak of <italic>Ralstonia insidiosa</italic> to its end, with emphasis on the control measures implemented by a pediatric referral hospital. Results: We found 19 cases in 19 epidemiological weeks, with an attack rate of 1.76%, mainly affecting children hospitalized for more than 14 days, with invasive devices, admitted to pediatric intensive care (PICU) and with underlying disease. The clinical presentation was characterized by vomiting, fever and cough. The control of the outbreak was archived based on the installation of epidemiological and antimicrobial surveillance approach. Conclusions: We conclude that <italic>Ralstonia insidiosa</italic> is an emerging nosocomial, opportunistic and antibiotic-resistant pathogen affecting children with risk factors (invasive devices, immunocompromised and admitted to PICU), in whom it causes morbidity and mortality; furthermore, decision making based on a combined approach of epidemiological and antimicrobial surveillance with available resources can serve to control the outbreak.
An outbreak of Ralstonia insidiosa in hospitalized children
(2025) Raúl Copana-Olmos; Maria Elena Calderon-Lopez; Wara Ledezma-Hurtado; Roxana Ramos-Cardenas; Hirma Calle-Cruz; Fatima Cano-Guzman
Dog bite injuries in children seen at a tertiary care hospital in Bolivia
(Sociedad Argentina de Pediatría, 2023) Raúl Copana-Olmos; Maria Elena Calderon-Lopez; Adriana Jove-Veizaga; Esther Ochoa-Ledezma; José A Gómez-Rocabado; N. Agui-Santivañez; B Wara Ledezma-Hurtado; María R García-Delgadillo
Introduction. The objective of this study is to describe the characteristics of dog bite injuries in children seen at a children's hospital in Bolivia. Population and methods. This was an observational, retrospective study in patients seen between 2017 and 2021. Results. A total of 769 patients were studied. Dog bite injuries accounted for 5.6% of emergency visits and 0.8% of hospitalizations. They were more frequent in children younger than 5 years (55.1%), in whom the following were observed: greater injury severity (p = 0.008), history of animal provocation (p = 0.048), known attacking animal (p < 0.036), domestic accident (p = 0.021), greater frequency of post-exposure prophylaxis with anti-rabies serum (p = 0.005), and maxillofacial area as the main region involved (p < 0.001). There were 3 deaths due to human rabies and 1 due to hypovolemic shock. Conclusion. Dog bite injuries are a frequent cause of visit to the emergency department and hospitalization in pediatrics and have specific characteristics in children younger than 5 years.
Relationship between sociodemographic, clinical, and laboratory characteristics and severity of COVID-19 in pediatric patients
(Public Library of Science, 2024) Cristian Roca; Adriana Asturizaga; Nelson Villca; Ramiro Cabrera; Raúl Copana-Olmos; Vladimir Aguilera-Avendaño; Claudia Estrada-Villarroel; Mariel Andrea Forest-Yepez; Marcia Torrez-Santos; Adela Felipa Magne-Calle
COVID-19 affects children less seriously than adults; however, severe cases and deaths are documented. This study objective is to determine socio-demographic, clinical and laboratory indicators associated with severe pediatric COVID-19 and mortality at hospital entrance. A multicenter, retrospective, cross-sectional study was performed in 13 tertiary hospitals in Bolivia. Clinical records were collected retrospectively from patients less than 18 years of age and positive for SARS-CoV-2 infection. All variables were measured at hospital entrance; outcomes of interest were ICU admission and death. A score for disease severity was developed using a logistic regression model. 209 patients were included in the analysis. By the end of the study, 43 (20.6%) of children were admitted to the Intensive care unit (ICU), and 17 (8.1%) died. Five indicators were independently predictive of COVID-19 severity: age below 10 years OR: 3.3 (CI95%: 1.1–10.4), days with symptoms to medical care OR: 2.8 (CI95%: 1.2–6.5), breathing difficulty OR: 3.4 (CI95%: 1.4–8.2), vomiting OR: 3.3 (CI95%: 1.4–7.4), cutaneous lesions OR: 5.6 (CI95%: 1.9–16.6). Presence of three or more of these risk factors at hospital entrance predicted severe disease in COVID-19 positive children. Age, presence of underlying illness, male sex, breathing difficulty, and dehydration were predictive of death in COVID-19 children. Our study identifies several predictors of severe pediatric COVID-19 and death. Incorporating these predictors, we developed a tool that clinicians can use to identify children at high risk of severe COVID-19 in limited-resource settings.
Sepsis Bundle Adherence and Early Vasopressor Administration in Pediatric Septic Shock: Secondary Analysis of Outcomes in a 2023 Multicenter Cohort in Bolivia
(Lippincott Williams & Wilkins, 2025) Raúl Copana-Olmos; Nils Cassón; Willmer Diaz-Villalobos; Victor Urquieta-Clavel; Mary Tejerina-Ortiz; M. Céspedes-Lesczinsky; Vladimir Aguilera-Avendaño; Maricruz Fernández-Vidal; Mariel Andrea Forest-Yepez; Danny Blanco-Espejo
Early initiation of vasoactive agents in children with septic shock and timely sepsis bundle completion were independently associated with lower hazard of mortality. Historically, in Bolivia in 2023, bundle adherence was suboptimal, yet feasible interventions were associated with greater odds of better outcomes in pediatric sepsis and septic shock.
Sepsis in Critically Ill Children in Bolivia: Multicenter Retrospective Evaluation of the Phoenix Criteria for Sepsis in a 2023 Cohort
(Lippincott Williams & Wilkins, 2025) Raúl Copana-Olmos; Nils Casson-Rodriguez; Willmer Diaz-Villalobos; Victor Urquieta-Clavel; Mary Tejerina-Ortiz; Carol Mendoza-Montoya; Maricruz Fernández-Vidal; Mariel Andrea Forest-Yepez; Danny Blanco-Espejo; Ibeth Rivera-Murguia
In this 2023, retrospective cohort of PICU patients with sepsis in Bolivia, we have found that the majority met the 2024 Phoenix sepsis criteria, but less than two-thirds met the SIRS-based criteria for diagnosis. However, the respiratory score in the Phoenix criteria overestimated the severity of respiratory dysfunction in more than half of the cohort, likely because the score does not take account of the Andean adaptation to high altitude, with higher oxygen carrying capacity.