Backgrounds:

SARS-CoV-2 variant Omicron (B.1.1.529) is causing the actual wave in Spain, leading to the highest cumulative incidence across the pandemic. It is not known whether this variant causes more severe disease in children.

Methods

Clinical features were collected from children attended at the Emergency Room (ER) at a secondary center in Madrid from December 20^th 2021 to January 2^nd 2022. Charts were reviewed 1 week after diagnosis to check potential complications. Data were compared to children with other variants included in the national COVID-19 database EPICO-AEP. In this comparison, 17 ambulatory patients with Omicron from other center were also included to make data more robust.

Results:

94/1360 children (9.6%) had COVID-19. In 16% of them, variant was identified: 87% Omicron, 13% Delta. Median age was 6.5 years, only 7% were >12 years. Final diagnosis were upper respiratory tract infection (URTI) 61/94 (65%), flu-like syndrome 15/94 (16%), gastroenteritis 7/94 (7%), fever without source (FWS) 3/94 (3%), and migraine or asthma flare 2/94 each (2%). Only 2/94 (2%) patients were hospitalized: a 3-year girl with features of bacterial pneumonia and an Omicron variant; and a 40-days-old infant with whooping-like cough with negative RT-PCR for both Bordetella pertussis and RSV. Hospitalization rate was similar in Omicron and Alpha variant waves (2% vs 4%, p=0.656). Compared to other waves, URTI, headache and fever were more frequent in the Omicron wave, while pneumonia and FWS were in previous waves.

Conclusions/Learning Points:

Children with COVID-19 and Omicron variant seem to have similar profile as other variants, only more fever and URTI and less pneumonia.. Most children were <12 years, which may be related to the high proportion of vaccinated adolescents in our population.

Backgrounds:

Multidrug resistant bacteria (MDRB) infections are a rising concern, especially those associated with healthcare environments. The aims of this study were to describe the characteristics of MDRB colonizations in paediatric patients admitted to a Haemato-Oncology ward and to establish the risk of having a MDRB infection in a patient previously colonised.

Methods

Multicentre prospective observational study from May 2021-March 2022 in Spain. Patients < 18 years with diagnosis of cancer or hematopoietic stem cell transplantation (HSCT) admitted to Hemato-Oncology wards, were included. Rectal and nasal swabs for MDRB detection were performed at inclusion and periodically during a 90-day follow-up period. Active infection surveillance was performed during follow-up.

Data of colonization at baseline is presented.

Results:

111 patients were included: Median age was 8 (±5,5) years and 60 (54,1%) were women. Most common diagnosis were leukemia (52;46.8%), solid tumour (43;38.7%), sickle cell disease (SCD) (6;5.4%) and lymphoma (4;3.6%). 20 (18%) had undergone a HSCT.

14 (12.6%) had a MDRB colonization at baseline and 3 (2.7%) a double colonization. MDRB detected were ESBL-producing enterobacteria (7;50%), carbapenemase-producing enterobacteria (6;42.9%), MDR-Pseudomonas (2;14.3%) and MRSA (1;7.1%). No MDR-Acinetobacter or vancomycin-resistant Enterococcus were detected. The main ESBL-producing enterobacteria was E. coli (75%) and the main carbapenemase detected, VIM (66.7%). Risk factors for MDRB colonization were SCD diagnosis (p=0.03) and a previous colonization (p<0.01). Children with colonizations were more likely to have a HSCT and their father’s were more likely to have been born abroad, with no statistical significance.

Conclusions/Learning Points:

Rates of ESBL and carbapenemase-producing enterobacteria colonization in a cohort of paediatric patients with cancer or SCT in Spain was high.

Children with SCD and a previous colonization have a higher risk