Carlos Rodrigo

• MD, PhD
• Chief Clinical OfficerHead of Department and Full Professor of Pediatrics at Germans Trias i Pujol University Hospital - Institut Català de la Salut and Autonomous University of Barcelona

Background Diagnosis of nontuberculous mycobacteria (NTM) infections remains a challenge. In this study, we describe the evaluation of an immunological NTM-interferon (IFN)-γ release assay (IGRA) that we developed using glycopeptidolipids (GPLs) as NTM-specific antigens. Methods We tested the NTM-IGRA in 99 samples from pediatric patients. Seventy...

Purpose: Children with bronchiolitis admiteed to the pediatric intensive care unit (PICU) for acute respiratory failure may require respiratory support with non-invasive ventilation (NIV). Enteral nutrition (EN) is associated with a reduction in hospital stay. Even so, guidelines do not specify on how to initiate, increase and maintain EN in these...

Objective: To evaluate a Zika virus screening program applied to asymptomatic exposed pregnant women. Methodology: Analysis of data generated during the roll out of a Zika screening program. We included socio-demographic data, ultrasounds, and serological results (IgM, IgG, and Plaque Reduction Neutralization Test; PRNT) from asymptomatic pregna...

Staphylococcus aureus is an extremely virulent pathogen that is capable of quickly evolving and developing antibiotic resistance. To overcome this problem, new antibiotics have been developed. Some of these have been licenced for use in clinical practice, mainly for the treatment of adults with acute skin and soft tissue infections, in addition to...

Background: We previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15-20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be ide...

Between 2014-2018, we evaluated the severity of 687 cases of bronchiolitis caused by Respiratory Syncytial Virus (RSV) in Catalonia, Spain. Compared to RSV-B, RSV-A cases required intensive care (aRR=1.44, P<0.01) and respiratory support (aRR=1.07, P<0.01) more often; hospital stay was one day longer (P<0.01). Subgroup identification may aid clinic...

The definition of pneumonia varies depending on the organization, institution, or healthcare setting. The World Health Organization defines pneumonia based on clinical findings obtained by visual inspection and timing of the respiratory rate: cough, difficulty breathing, with or without fever, with either age-appropriate tachypnea or intercostal re...

Background: Viral lower respiratory tract infections (LRTI) are the leading cause of hospitalization in children. In Catalonia (Spain), information is scarce about the burden of viral LRTIs in paediatric hospitalizations. The aim of this study is to describe epidemiological, clinical, virological and economic features of paediatric hospitalization...

There is a lack of evidence of the health impacts due to long COVID among children and young people (CYP). The objective of this study is to determine the main clinical characteristics of long COVID in CYP and to investigate the academic, social, and health status impacts of long COVID in this population. An observational, descriptive, and longitud...

Numerous studies have explored whether and how the spread of the coronavirus disease 2019 (COVID-19) responds to environmental conditions without reaching unique or consistent answers. Sociodemographic factors such as variable population density or mobility as well as the lack of effective epidemiological monitoring difficult establishing robust co...

Background Most children and adolescents infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain asymptomatic or develop a mild coronavirus disease 2019 (COVID-19) that usually does not require medical intervention. However, a small proportion of pediatric patients develop a severe clinical condition, multisystem infla...

To determine molecular epidemiology and clinical features of enterovirus D68 (EV-D68) infections, we reviewed EV-D68-associated respiratory cases at a hospital in Barcelona, Spain, during 2014-2021. Respiratory samples were collected from hospitalized patients or outpatients with symptoms of acute respiratory tract infection or suggestive of entero...

Professionals that work in neonatal units need to identify the strengths and weaknesses of the premature infant who is in the transition process from feeding through a gastric tube to oral feeding. The main aim of this study was to validate the Oral FEeding Assessment in premaTure INfants (OFEATINg) instrument. A psychometric validity and reliabili...

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection became a pandemic in 2020 and by March 2022 had caused more than 479 million infections and 6 million deaths worldwide. Several acute and long-term symptoms have been reported in infected adults, but it remains unclear whether children/adolescents also experience persistent...

Bordetella pertussis not expressing pertactin has increased in countries using acellular pertussis vaccines (ACV). The deficiency is mostly caused by pertactin gene disruption by IS481. To assess the effect of the transition from whole-cell vaccine to ACV on the emergence of B. pertussis not expressing pertactin in Spain, we studied 342 isolates co...

Background Bronchiolitis caused by the respiratory syncytial virus (RSV) is the main reason for hospitalization in infants. Supportive care is the mainstay of treatment, and tests are restricted to a few indications. During 2015, our hospital bronchiolitis protocol (2015 HBP) was updated according to the latest practice guidelines.Objective The obj...

Objective To reduce radiation exposure in newborns admitted due respiratory distress based on the implementation of lung ultrasound (LUS). Design Quality improvement (QI), prospective, before-after, pilot study. Setting Third level neonatal intensive care unit (NICU) level with 25-bed and 1800 deliveries/year. Patients Inclusion criteria were ne...

The pediatric population is a vulnerable group for adverse drug reactions (ADRs), and data on spontaneous reporting of ADRs in the hospital setting are scarce. We conducted a retrospective analysis of ADRs in pediatric patients spontaneously reported by health care professionals to a Pharmacovigilance Program in a tertiary hospital between 2010 and...

Background: Between April and June 2016, an outbreak of rhombencephalitis (RE) caused by enterovirus (EV) A71 was detected in Catalonia, Spain-the first documented in Western Europe. The clinical characteristics and outcome of patients with this condition differed from those reported in outbreaks occurring in Southeast Asia. Methods: Observation...

Self-harm in the paediatric population is an emerging problem that has been associated with disability and an increased risk of suicide. The objective of the study is to analyse the prevalence of self-harming behaviour as a reason for paediatric emergency consultations.

Objective To develop an Overall Pediatric Health Standard Set (OPH-SS) of outcome measures that captures what matters to young people and their families and recognising the biopsychosocial aspects of health for all children and adolescents regardless of health condition. Design A modified Delphi process. Setting The International Consortium for H...

Análisis de una serie de pacientes con clínica moderada ingresados en una unidad COVID-19 creada ex profeso 71 Rev Enf Emerg 2020;19(2):71-79 Original Resumen Introducción: En este estudio presentamos los datos clínicos y demográficos y los factores asociados a la evolución clínica de los pacientes con clínica moderada COVID-19 en una unidad creada...

Community-acquired pneumonia (CAP) is a prevalent disease among children and is frequently associated with both diagnostic and therapeutic uncertainties. Consensus has been reached between SEPAR, SENP and SEIP, and their conclusions are as follows: Etiology depends mainly on age and other factors and no single analytical marker offers absolute diag...

Clinical diagnosis of influenza has low sensitivity in infants and children. Signs and symptoms are non-specific and similar to those of other respiratory viruses. Rapid influenza diagnostic tests (RIDTs) with adequate sensitivity and specificity used at the point of care can be useful for an etiologic diagnosis of influenza in primary care. This s...

Análisis de una serie de pacientes con clínica moderada ingresados en una unidad COVID-19 creada ex profeso 71 Rev Enf Emerg 2020;19(2):71-79 Original Resumen Introducción: En este estudio presentamos los datos clínicos y demográficos y los factores asociados a la evolución clínica de los pacientes con clínica moderada COVID-19 en una unidad creada...

Introducción: En este estudio presentamos los datos clínicos y demográficos y los factores asociados a la evolución clínica de los pacientes con clínica moderada COVID-19 en una unidad creada exprofeso. Materiales y métodos: Estudio transversal retrospectivo que incluyó pacientes ingresados y que finalizaron su curso clínico entre entre el 25 de m...

Resumen La neumonía adquirida en la comunidad (NAC) es una enfermedad prevalente en la edad pediátrica y que ofrece frecuentemente dudas tanto diagnósticas como terapéuticas. Se ha realizado un consenso entre SEPAR, SENP y SEIP, con las siguientes conclusiones: 1.La etiología depende fundamentalmente de la edad y de otros factores, como estado inmu...

Resumen El 31 de diciembre de 2019, la Comisión Municipal de Salud y Sanidad de Wuhan (provincia de Hubei, China) informó sobre la existencia de 27 casos de neumonía de etiología desconocida con inicio de síntomas el 8 de diciembre, incluyendo 7 casos graves, con exposición común a un mercado de marisco, pescado y animales vivos en la ciudad de Wuh...

Las recomendaciones incluidas en el presente documento están en continua revisión y podrán ser modificadas si la situación epidemiológica y las opciones terapéuticas así lo requieren. Consulta disponible en: https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/Protocolo_manejo_clinico_COVID-19.pdf

Among the factors associated with the resurgence of whooping cough, special emphasis has been given to pathogen adaptation after the introduction of the acellular vaccine (ACV). To assess the impact of the vaccine transition strategy from whole-cell vaccine (WCV) to ACV on population dynamics of Bordetella pertussis in Barcelona (Spain), we studied...

A progressive increase in the incidence of infections caused by multidrug-resistant microorganisms is being reported. Among these resistant microorganisms, the main threats are extended-spectrum β-lactamase-, AmpC-, and carbapenemase-producing Gram-negative bacilli, methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus f...

A progressive increase in the incidence of infections caused by multidrug-resistant microorganisms is being reported. Among these resistant microorganisms, the main threats are extended-spectrum β-lactamase-, AmpC-, and carbapenemase-producing Gram-negative bacilli, methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus f...

Pertussis is an acute respiratory disease caused by Bordetella pertussis. Due to its frequency and severity, prevention of pertussis has been considered an important public health issue for many years. The development of the whole-cell pertussis vaccine (wPV) and its introduction into the pediatric immunization schedule was associated with a marked...

Host susceptibility to respiratory tract infections (RTI) is dependent on both genetic and acquired risk factors. Repeated bacterial and viral RTI, such as pneumonia from encapsulated microorganisms, respiratory tract infections related to respiratory syncytial virus or influenza, and even the development of bronchiectasis and asthma, are often rep...

Urinary tract infection (UTI) is defined as the growth of microorganisms in a sterile urine culture in a patient with compatible clinical symptoms. The presence of bacteria without any symptoms is known as asymptomatic bacteriuria, and does not require any treatment. In neonates and infants, fever is the guiding sign to suspecting a UTI. Classic ur...

Aim: To describe the genetic diversity of enteroviruses (EV) causing hand, foot and mouth disease (HFMD) and herpangina, especially of coxsackievirus (CV)-A6, from patients attended at pediatric primary care centers during the 2017-2018 season. Methods: Phylogenetic analysis of partial VP1 region was performed for genetic characterization. The comp...

Resumen La infección del tracto urinario se define como el crecimiento de microorganismos en orina recogida de forma estéril, en un paciente con síntomas clínicos compatibles. En ausencia de sintomatología el aislamiento de bacterias en urocultivo se denomina bacteriuria asintomática y no precisa tratamiento. En neonatos y lactantes el signo guía p...

Introduction Influenza is a generally a benign disease, but occasionally it can cause serious complications. There is controversy about the benefits of antiviral treatment. Objectives To provide some recommendations on the treatment with oseltamivir in paediatric patients with influenza, based on the best data available and valid in our environmen...

Introduction The aim of this study was to assess the safety and efficacy of ledipasvir/sofosbuvir combination in chronic Hepatitis C Virus (HCV) genotype 1 and 4 infection in paediatric patients. Methods Eligible patients to be treated with ledipasvir/sofosbuvir were patients from 6 to 18 years old with a chronic HCV genotype 1 or 4 infection. The...

Influenza is often misdiagnosed in children because of the low sensitivity of clinical diagnosis due to nonspecific signs and symptoms. This can be overcome by using digital immunoassays or rapid molecular diagnostic tests with adequate sensitivity and specificity. When using these tests at the patient care site, antibiotic consumption and number o...

Objectives: The aim was to describe pregnancy outcomes after Zika virus (ZIKV) infection in a non-endemic region. Methods: According to the Spanish protocol issued after the ZIKV outbreak in Brazil in 2015, all pregnant women who had travelled to high-burden countries were screened for ZIKV. Serological and molecular tests were used to identify...

Resumen Introducción La gripe es una enfermedad generalmente benigna, pero en ocasiones puede ocasionar complicaciones graves. Existe controversia sobre los beneficios del tratamiento con antivirales. Objetivos Proporcionar unas recomendaciones sobre el tratamiento con oseltamivir en pacientes pediátricos con gripe, basadas en los mejores datos d...

Introduction There are only a limited number of studies on the impact of influenza in the Spanish child population. The present work intends to increase this knowledge by studying some key aspects, such as the incidence of hospital admissions, clinic variables, comorbidities, and the vaccination status in the hospitalised children. Methods A retro...

Background: Enterovirus (EV) infections are usually asymptomatic or mild, but symptomatic infections can evolve to severe complications. Outbreaks of EV-A71 and EV-D68 have been recently reported worldwide, sometimes related to severe clinical outcomes. Objective: To describe EV genetic diversity and the clinical outcomes from paediatric patient...

Introduction and objective The purpose of this study was to describe the evolution of meningococcal disease (MD) in the city of Barcelona between 1988 and 2015 and to assess the impact of the vaccine against serogroup C. Materials and methodology The evolution of MD and by serogroup was analyzed using the information included in the mandatory noti...

Introduction: Hepatitis C virus infection is world health problem. The aim of this study was to assess the safety and efficacy of ledipasvir/sofosbuvir combination in chronic Hepatitis C Virus (HCV) genotype 1 and 4 infection in paediatric patients. Methods: Eligible patients to be treated with ledipasvir/sofosbuvir were patients from 6 to 18 ye...

Introduction: There are only a limited number of studies on the impact of influenza in the Spanish child population. The present work intends to increase this knowledge by studying some key aspects, such as the incidence of hospital admissions, clinic variables, comorbidities, and the vaccination status in the hospitalised children. Methods: A r...

Introduction and objective: The purpose of this study was to describe the evolution of meningococcal disease (MD) in the city of Barcelona between 1988 and 2015 and to assess the impact of the vaccine against serogroup C. Materials and methodology: The evolution of MD and by serogroup was analysed using the information included in the mandatory...

We describe the detection of Bordetella holmesii as a cause of whooping cough in Spain. Prevalence was 3.9% in 2015, doubling to 8.8% in 2016. This emergence raises concern regarding the contribution of B. holmesii to the reemergence of whooping cough and the effectiveness of the pertussis vaccine.

Pediatric acute liver failure (p-ALF) results in death or the need for liver transplantation (LT) in approximately 25%-50% of patients. Despite the existence of emergency channels for organ allocation, between 15% and 22% of p-ALF patients die while awaiting highurgency LT.(1) Extracorporeal liver support systems (ELSs) are increasingly applied as...

Objectives: To describe a case of a pregnant woman with Zika virus infection and severe fetal brain malformations. Methods: Serial ultrasound measurements, fetal magnetic resonance imaging results, laboratory and amniocentesis results, and perinatal outcomes of the pregnant woman and her neonate are reported. Results: Zika virus tested positiv...

IntroductionLiver–kidney transplantation is a rare procedure in children, with just ten to 30 cases performed annually worldwide. The main indications are autosomal recessive polycystic liver–kidney disease and primary hyperoxaluria. This study aimed to report outcomes of liver–kidney transplantation in a cohort of pediatric patients. Methods We re...

Objectives: To assess the safety and efficacy of conversion from twice-daily tacrolimus to once-daily tacrolimus in pediatric liver transplant recipients. Methods: Conversion from twice-daily to once- daily tacrolimus was made in stable pediatric liver transplant recipients. Doses and serum levels of tacrolimus, liver and renal function were rec...

Enterovirus D68 was known to be the cause of mild to severe respiratory infections, but in the last few years it has also been associated with myelitis and paralysis. This report describes the first EV-D68 detections in acute flaccid paralysis cases occurring between December 2015 and March 2016 in Spain.

Aim: To describe the circulation, genetic diversity and clinical features of human metapneumovirus (HMPV) in pediatric patients that attended the Hospital Universitari Vall d'Hebron, Spain from 2014 to 2016. Materials & methods: Partial G gene was sequenced from laboratory-confirmed HMPV respiratory specimens for subsequent phylogenetic analysis...

Blood culture (BC) is the gold standard when a bacteraemia is suspected, and is one of the most requested microbiological tests in paediatrics. Some changes have occurred in recent years: the introduction of new vaccines, the increasing number of patients with central vascular catheters, as well as the introduction of continuous monitoring BC syste...

Blood culture (BC) is the gold standard when a bacteraemia is suspected, and is one of the most requested microbiological tests in paediatrics. Some changes have occurred in recent years: the introduction of new vaccines, the increasing number of patients with central vascular catheters, as well as the introduction of continuous monitoring BC syste...

Background Rotaviruses are the leading cause of severe acute gastroenteritis in children aged <5 years worldwide. A live attenuated human rotavirus vaccine, RIX4414 has been developed to reduce the global disease burden associated with rotavirus gastroenteritis. Serum anti-rotavirus immunoglobulin A (IgA) antibody measured in unvaccinated infants d...

This is a Consensus Document of the Spanish Society of Paediatric Infectious Diseases (Sociedad Española de Infectología Pediatrica), Spanish Society of Paediatric Rheumatology (Sociedad Española de Reumatología Pediátrica) and the Spanish Society of Paediatric Orthopaedics (Sociedad Española de Ortopedia Pediátrica), on the treatment of uncomplica...

This is a Consensus Document of the Sociedad Española de Infectología Pediátrica, Sociedad Española de Reumatología Pediátrica and Sociedad Española de Ortopedia Pediátrica on the aetiology and diagnosis of uncomplicated acute osteomyelitis and septic arthritis. A review is presented of the aetiopathogenesis and pathophysiology of acute osteoarticu...

This is a Consensus Document of the Sociedad Española de Infectología Pediátrica, Sociedad Española de Reumatología Pediátrica and Sociedad Española de Ortopedia Pediátrica on the aetiology and diagnosis of uncomplicated acute osteomyelitis and septic arthritis. A review is presented of the aetiopathogenesis and pathophysiology of acute osteoarticu...

Importance No studies have systematically examined the accuracy of clinical, laboratory, and imaging variables in detecting renal scarring in children and adolescents with a first urinary tract infection.Objectives To identify independent prognostic factors for the development of renal scarring and to combine these factors in prediction models th...

Most scoliosis are idiopathic (80%) and occur more frequently in adolescent girls. Plain radiography is the imaging method of choice, both for the initial study and follow-up studies but has the disadvantage of using ionizing radiation. The breasts are exposed to x-ray along these repeated examinations. The authors present a range of recommendation...

Objective: Performance of IFN-γ assays in children is compromised. Therefore, we investigated the utility of IP-10 for the detection of active tuberculosis (TB) and latent tuberculosis infection (LTBI) diagnosis in children; comparing its positivity with QuantiFERON-TB Gold In-Tube (QFN-G-IT) and T-SPOT.TB. Methods: We studied 230 children from...