Background: Data on the health impact of carbapenem-resistant Enterobacteriaceae bloodstream infections (CRE-BSIs) in pediatric populations from Latin America and the Caribbean (LAC) are limited. This systematic review aims to examine the demographic, clinical, and microbiological aspects and resource utilization of this infection in children from this region. Methods: This systematic review investigates the impact of CRE-BSIs in pediatric populations across LAC. Following the Cochrane methodology and PRISMA/MOOSE guidelines, we conducted an extensive search of different databases, including MEDLINE/PubMed, LILACS (SciELO), CENTRAL, CINAHL, Embase (Ovid), the Cochrane Library, and the World Health Organization (WHO) database, and relevant websites for published articles between January 2012 and September 2024. The review included studies on hospitalized patients under 19 years of age with CRE-BSIs. Results: Fourteen studies involving 189 patients were analyzed. Most cases were reported from Brazil, Argentina, Colombia, and Paraguay. The median age of the patients was 35 months. Key risk factors included immunocompromised status, invasive procedures, carbapenem use, and colonization. The infections were predominantly hospital-acquired, with Klebsiella pneumoniae and Serratia spp. being the most common pathogens. KPC and NDM were the primary resistance mechanisms. Most patients received combination antimicrobial therapy for a median of 17 days. An alarmingly high mortality rate at 34% was found. Conclusions: Our findings highlight that CRE-BSIs pose a significant threat to children with underlying conditions in LAC, leading to substantial morbidity and mortality. Implementing robust antimicrobial stewardship programs and effective infection control measures are crucial to curbing the spread of CRE-BSIs in the region. This review underscores the need for targeted interventions and further research to address this critical public health concern in pediatric populations across LAC.

Background: In 2020, countries implemented universal surveillance to detect and monitor severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases. Although crucial for early monitoring efforts, universal surveillance is resource intensive. To understand the implications of transitioning from universal to sentinel surveillance for monitoring SARS-CoV-2 transmissibility, morbidity and mortality, and disease seriousness, we compared measures of SARS-CoV-2 reported from both surveillance strategies in Argentina, Chile, and Mexico. Methods: We obtained weekly case counts in Argentina, Chile, and Mexico, in periods when both universal and sentinel surveillance were ongoing. To assess the countries' surveillance strategies, we measured the proportion of total sites that were included in sentinel surveillance. We compared 8 measures of SARS-CoV-2 transmissibility, morbidity and mortality, and disease seriousness between sentinel and universal surveillance and assessed the correlation between the 2 strategies for the 8 measures. Pearson and Spearman correlation was classified as very strong (rs = 0.8–1.0), strong (rs = 0.60–0.79), moderate (rs = 0.50–0.59), or poor (r < 0.50). Results: The proportion of total sites included in sentinel surveillance was 5.8% for Argentina, 1.1% for Chile, and 7.6% for Mexico. A total of 21 measures were calculated (8 for Mexico, 8 for Chile, and 5 for Argentina). Of these, 17 showed consistency between the 2 surveillance strategies, with strong or very strong correlations (r = 0.66–0.99): all 8 measures for Mexico, 6 of 8 measures for Chile, and 3 of 5 measures for Argentina. Each country had ≥1 measure reflecting transmissibility and ≥1 reflecting morbidity and mortality for which the correlation was strong or very strong. Chile and Mexico also had ≥1 measure of disease seriousness for which the correlation was strong. Conclusions: Our findings suggest that the integration of SARS-CoV-2 into national sentinel surveillance can yield information comparable to that provided by nationwide universal surveillance for measures related to SARS-CoV-2 transmissibility, morbidity and mortality, and seriousness of disease.

Background: We estimate annual viral influenza-associated mild-to-moderate illness, hospitalizations, and deaths in 6 South American countries (Argentina, Brazil, Chile, Ecuador, Paraguay, and Uruguay) during the 2015–2019 influenza seasons as a first step in evaluating the full value of influenza vaccination in the subregion. Methods: We applied a multiplier method using monthly hospital discharge and vital statistics death records, influenza surveillance data, and population projections to estimate mild-to-moderate influenza-associated illness, hospitalizations, and deaths. We estimated the uncertainty bounds based on the 2.5th and 97.5th percentiles of the Monte Carlo simulated distributions for the number of cases and obtained the ranges from the minimum value of the 2.5th and the maximum value of the 97.5th percentile. Results: In selected countries with a total population of 307 million people, the yearly influenza-associated burden of disease ranged between 51 and 78 million mild-to-moderate influenza illnesses, between 323 379 and 490 049 hospitalizations, and between 22 662 and 46 971 deaths during the 2015–2019 influenza seasons. Conclusions: Each year, influenza is associated with millions of illnesses, hundreds of thousands of hospitalizations, and tens of thousands of deaths in 6 South American countries, affecting a significant portion of the population. Such findings can be used to estimate the number of illnesses averted through vaccination programs and the cost-benefit of influenza vaccines.