Resumen Introducción: En los niños, la bacteriemia debida a Burkholderia cepacia, es considerada una complicación grave y conducente a una elevada mortalidad. Con el objetivo de conocer la mortalidad asociada a esa condición, se realizó una revisión sistemática de la literatura médica. Material y Métodos: Se aplicó una estrategia de búsqueda bibliográfica con las palabras claves: “bacteriemia por B. cepacia”, “humanos”, “niños” y “adolescentes”, como únicos filtros. Se informan la mediana y los valores intercuartílicos de la frecuencia de la mortalidad reportada por los estudios incluidos. Resultados: Se identificaron 92 estudios potencialmente útiles. De ellos, se descartaron 81, incluyéndose finalmente, 11 estudios. Se trató de descripciones retrospectivas de casos, salvo uno de ellos, que respondió a un diseño analítico caso-control. La mediana de la mortalidad reportada por esta revisión, fue 0 (Q25 = 0 y Q75 = 28,57%). Interpretación: Si bien la evidencia disponible es escasa y de baja calidad, sugiere que el curso clínico de esta afección no siempre resulta en una elevada mortalidad.

Abstract Background: Bacteremia due to Burkolderia cepacia in children is considered a severe complication and associated with high mortality incidence. In order to know the level of mortality associated with it, this systematic review of the literature was carried out. Methods: A search strategy was carried out with the keywords: “bacteremia by B cepacia and human” and “children” and “adolescents” as filters. Global frequency of mortality reported by the included studies was calculated and informed as median (Q2) and its interquartile values (Q1 and Q3). Results: The search identified 92 potentially useful studies. Of these, 81 were discarded, and then remained 11 studies to be included. One out of 11 studies is an analytic case-control design. Rest are retrospective case series. Related mortality median was 0 (Q25 = 0 and Q75 = 28,57%). Conclusion: Although the available evidence is scarce and of low quality, it suggests that clinical course of this condition does not always lead to high mortality rates.

Studies about risk factors for mortality in burn children are scarce. We conducted this study to evaluate the risk factors for mortality in pediatric burn patients. We included 110 patients. Mean age was 31.5 months (range: 1 to 204). The burn surface was between 1% and 95%(median 27%) Type of burn was: A or superfitial in 39 patients (36%), AB or intermediate in 19 (17%), and B or full thickness in 52 (47%). Inhalatory injury was present in 52 patients (47%). Invasive procedures were: venous catheter, 90 patients (82%), arterial catheter, 83patients (75.5%), urinary catheter, 86 patients (78%), and mechanical ventilation, 75 patients (68%). In 84 patients, 128 infections were diagnosed. in 53 cases (48%). Multiresistant Pseudomonas aeruginosa and Acynetobacter baumannii were the most common organisms isolated. The median length of hospital stay was 33 days (r: 8-139 days). Seventeen patients (15%) died and 14 of them of infection-related causes. Age< <4 years, Garcés 4, full thickness burn, > 40% burn surface, presence of inhalatory syndrome, use of venous catheter, arterial catheter, urinary catheter and mechanical ventilation, positive blood cultures, colistin use in documented multiresistant infections, antifungal use and graft requirement, were identified as risks factors for mortality in the univariate analysis. By multivariate analysis: age <4 years, Garcés 4, colistin use in multiresistant infections, mechanical ventilation and graft requirement were independent variables related with mortality.CONCLUSIONS:In this series of burn children age < 4 years, Garces index score 4, colistin use in documented multiresistant infections, mechanical ventilation and graft requirement were identified as independent variables related with mortality.

Infections after cardiovascular surgery are an important cause of morbidity and mortality. This paper described the study of risk factors associated with development of infections. This is a prospective study, setting in a Hospital JP Garrahan, a tertiary and referral center of Buenos Aires, Argentina. All patients with cardiac surgeries between 1/11/01 to 1/1/ 2002 were included. The median age of p was 30 months (r: 1-212 m), 184 p (53%) were boys, 21% (75) had underlying disease, being the genetic disorders or undernutrition the most frequent, 56 p (16%) had previous surgery, 36 p (10%) had received previous antibiotics and 30 (9%) of them had previous infection, An ASA score higher than or equal to 3 was found in 308 p (88%). Median hospital stay before surgery was 1 day (r1-120 d), 88 p (25%) nedeed inotropic support with epinephrine, 147 p (42%) needed mechanical ventilation during a median time of 4 days (r: 1-66d).Drainage with thorax opened was done in 339p (97%) for a median time of 2 days (r:1-7d). Total hospital stay was between 1 and 120 days (median 5 days). Postsurgical infections developed in 38 of 350p (11%). Superficial wound infection in 4 p (1%), 5 p (1.5%) had deep infection, 3p (1%) had mediastinitis and 26 p (7.5%) had other nonsurgical infections Eleven p (3%) died. By multivariate study underlying diseases (p<0.012) OR 4.22 (CI 1.38-12.8), inotropic support with epinephrine (p<0.027) OR 4.04 (CI 1.17-13.9) and postoperative stay longer than 12 days were found to be risk factors for infections. We concluded that presence of underlying diseases, longer hospitalization and inotropic support were risk factors for infections.