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grupo de edad en el que&#44; adem&#225;s&#44; se produce el mayor n&#250;mero de complicaciones y mortalidad&#46; Canarias es una de las comunidades aut&#243;nomas en donde se registran las tasas m&#225;s elevadas de Espa&#241;a<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">5</span></a>&#46; En el per&#237;odo 2003-2007 realizamos un estudio&#44; en el que observamos un alto porcentaje de complicaciones y mortalidad en este grupo de edad<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">6</span></a>&#46; Por esto&#44; desde el a&#241;o 2015&#44; en nuestra comunidad&#44; se ha incorporado la vacunaci&#243;n a las mujeres embarazadas&#46; Con el objetivo de conocer la evoluci&#243;n de la infecci&#243;n&#44; hemos realizado un estudio cl&#237;nico-epidemiol&#243;gico de todos los casos diagnosticados en menores de un a&#241;o que acudieron al Servicio de Urgencias del &#250;nico hospital pedi&#225;trico p&#250;blico de la isla de Gran Canaria entre los a&#241;os 2008 y 2016&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Pacientes</span><p id="par0010" class="elsevierStylePara elsevierViewall">Se incluyeron en el estudio los 1&#46;040 pacientes menores de un a&#241;o que acudieron al Servicio de Urgencias del hospital Materno Infantil de Gran Canaria &#40;que cubre una poblaci&#243;n media de 6&#46;770 menores de un a&#241;o&#41; con un cuadro cl&#237;nico por el cual se solicit&#243; descartar la infecci&#243;n por <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span>&#44; de enero de 2008 a diciembre de 2016&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">M&#233;todos</span><p id="par0015" class="elsevierStylePara elsevierViewall">En todos los pacientes se investig&#243; la presencia de <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span> por reacci&#243;n en cadena de la polimerasa &#40;PCR&#41; &#40;<span class="elsevierStyleItalic">LightMix Kit Bordetella pertussis&#47;parapertussis</span> o <span class="elsevierStyleItalic">Diagenode Bordetella pertussis&#47;parapertussis</span>&#41; en muestras de exudado nasofar&#237;ngeo obtenidas con escobill&#243;n flexible&#46; En 581 pacientes &#40;55&#44;9&#37;&#41;&#44; adem&#225;s&#44; se investig&#243; la presencia de virus en muestras de lavado nasofar&#237;ngeo&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Se revisaron retrospectivamente las historias cl&#237;nicas de los pacientes con un resultado positivo para <span class="elsevierStyleItalic">B&#46; pertussis</span>&#44; analizando las variables demogr&#225;ficas&#44; antecedentes de vacunaci&#243;n&#44; fuente probable de infecci&#243;n &#40;persona con cuadro cl&#237;nico compatible con tosferina en contacto con el ni&#241;o&#41;&#44; sintomatolog&#237;a&#44; datos de laboratorio y tratamiento&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Para el an&#225;lisis estad&#237;stico de los resultados se utiliz&#243; la prueba de Mann-Whitney para comparar variables cuantitativas y la de chi cuadrado para comparar proporciones&#46; Se consider&#243; significaci&#243;n estad&#237;stica un valor de <span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;0&#44;05&#46; El estudio fue aprobado por el Comit&#233; Local de Bio&#233;tica e Investigaci&#243;n&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Epidemiolog&#237;a</span><p id="par0030" class="elsevierStylePara elsevierViewall">En 110 pacientes &#40;10&#44;6&#37;&#41; se detect&#243; infecci&#243;n por <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span>&#46; En otros 269 pacientes &#40;25&#44;7&#37;&#41; se detect&#243; otro pat&#243;geno &#40;en 175 virus respiratorio sincitial&#44; en 33 rinovirus&#44; en 32 parainfluenza 3&#44; en 7 metapneumovirus&#44; en 5 citomegalovirus&#44; en 5 influenza A&#44; en 4 influenza B&#44; en 3 enterovirus&#44; en 2<span class="elsevierStyleHsp" style=""></span>parainfluenza 1&#44; en 2<span class="elsevierStyleHsp" style=""></span>parainfluenza 2 y en uno virus Coxsackie B&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">De los 110 ni&#241;os con infecci&#243;n por <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span>&#44; 65 eran varones &#40;59&#44;1&#37;&#41;&#44; la edad media fue de 83&#44;3 d&#237;as &#40;rango 14-287&#41; y 105 &#40;95&#44;4&#37;&#41; eran menores de 6 meses&#46; Once ni&#241;os nacieron prematuros &#40;10&#44;0&#37;&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> se muestra la incidencia anual de casos de tosferina por 100&#46;000 ni&#241;os menores de un a&#241;o que acudieron al hospital&#46; La tasa de incidencia anual oscil&#243; entre 13&#44;7 casos en el a&#241;o 2009 y 425&#44;0 casos en el a&#241;o 2015&#44; con 2<span class="elsevierStyleHsp" style=""></span>picos en los a&#241;os 2011 y 2015&#46; Desde el a&#241;o 2010&#44; el a&#241;o con menor incidencia de casos fue 2016&#46; Por estaciones&#44; el 33&#44;6&#37; de los casos se produjeron en verano&#44; el 29&#44;1&#37; en primavera&#44; el 19&#44;1&#37; en invierno y el 18&#44;2&#37; en oto&#241;o&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Con relaci&#243;n al estado vacunal&#44; 56 ni&#241;os &#40;50&#44;9&#37;&#41; no hab&#237;an iniciado el calendario de vacunaci&#243;n&#44; 47 &#40;42&#44;7&#37;&#41; hab&#237;an recibido una dosis&#44; 5 &#40;4&#44;5&#37;&#41; 2<span class="elsevierStyleHsp" style=""></span>dosis y 2<span class="elsevierStyleHsp" style=""></span>&#40;1&#44;8&#37;&#41; 3<span class="elsevierStyleHsp" style=""></span>dosis&#46; Solo uno de los ni&#241;os no estaba correctamente vacunado para su edad&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">En 45 pacientes &#40;40&#44;9&#37;&#41; se document&#243; la posible fuente de infecci&#243;n&#44; que fue en 44 casos &#40;97&#44;8&#37;&#41; la transmisi&#243;n familiar y en un caso fue nosocomial&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Diecisiete ni&#241;os con tosferina nacieron despu&#233;s de la incorporaci&#243;n de la vacunaci&#243;n en la gestante&#59; de estos&#44; en 5 &#40;29&#44;4&#37;&#41; la madre hab&#237;a recibido la vacuna en el tercer trimestre de embarazo &#40;una en la semana 28&#44; una en la semana 31 y en las otras 3 no consta la semana de gestaci&#243;n&#41;&#46; La edad media de los 5 ni&#241;os fue de 2&#44;8 meses &#40;rango 0-5&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Manifestaciones cl&#237;nicas</span><p id="par0065" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se recogen las caracter&#237;sticas cl&#237;nicas y las alteraciones anal&#237;ticas de los 110 pacientes&#46; El cuadro cl&#237;nico t&#237;pico se caracteriz&#243; por la presencia de tos pertusoide&#44; con signos catarrales&#44; cianosis y linfocitosis&#46; La &#250;nica diferencia con relaci&#243;n a las caracter&#237;sticas cl&#237;nicas entre los ni&#241;os mayores y menores de 3 meses fue la neumon&#237;a&#44; que se present&#243; solo en menores de 3 meses &#40;<span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;0&#44;01&#41;&#46; El tiempo medio desde el inicio de los s&#237;ntomas hasta que acudieron al Servicio de Urgencias fue de 9&#44;0&#160;&#177;&#160;5&#44;9 d&#237;as &#40;rango&#58; 1-28&#41;&#46; Ingresaron 107 pacientes &#40;97&#44;3&#37;&#41;&#44; con un tiempo medio de ingreso de 10&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;3 d&#237;as &#40;rango&#58; 0-45&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Presentaron complicaciones 17 pacientes &#40;15&#44;4&#37;&#41;&#58; 10 casos de neumon&#237;a y 7 de apnea&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se muestran las caracter&#237;sticas de los ni&#241;os que presentaron complicaciones&#58; el 82&#44;3&#37; de los ni&#241;os no hab&#237;an iniciado la vacunaci&#243;n y el resto solo hab&#237;an recibido una dosis&#46; Nueve ni&#241;os con neumon&#237;a ingresaron en la Unidad de Cuidados Intensivos&#46; Una ni&#241;a de 42 d&#237;as &#40;caso 1&#41; que ingres&#243; en dicha unidad present&#243; inicialmente un recuento de leucocitos de 27&#46;200&#47;&#956;l&#44; pero a los 13 d&#237;as del cuadro lleg&#243; a presentar una hiperleucocitosis &#40;103&#46;000 leucocitos&#47;&#956;l&#41; por lo que se le practic&#243; una exsanguineotransfusi&#243;n de doble volemia&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestran las diferencias entre los ni&#241;os que presentaron complicaciones y los que no&#46; En ella se observa que los ni&#241;os que presentaron complicaciones ten&#237;an una edad menor y&#44; en un alto porcentaje&#44; no hab&#237;a iniciado el calendario vacunal&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Todos los pacientes recibieron tratamiento desde el momento del ingreso con azitromicina &#40;10<span class="elsevierStyleHsp" style=""></span>mg&#47;kg al d&#237;a&#41; durante 5 d&#237;as &#40;salvo uno que lo recibi&#243; 10 d&#237;as&#41; y la evoluci&#243;n fue buena&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Coinfecciones con otros pat&#243;genos</span><p id="par0080" class="elsevierStylePara elsevierViewall">En 57 pacientes &#40;51&#44;8&#37;&#41; con infecci&#243;n por <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span> se investig&#243; la presencia de virus y en 18 &#40;31&#44;6&#37;&#41; se detect&#243; coinfecci&#243;n&#58; 9 con rinovirus&#44; 3<span class="elsevierStyleHsp" style=""></span>parainfluenza 3&#44; 2<span class="elsevierStyleHsp" style=""></span>virus respiratorio sincitial&#44; uno adenovirus&#44; uno virus influenza C&#44; uno citomegalovirus y uno con virus Coxsackie B&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discusi&#243;n</span><p id="par0085" class="elsevierStylePara elsevierViewall">A pesar de la amplia cobertura vacunal en la poblaci&#243;n pedi&#225;trica&#44; la tosferina sigue siendo un problema de salud p&#250;blica&#44; por lo que&#44; recientemente&#44; se introdujo la vacunaci&#243;n en el embarazo en nuestra comunidad&#44; con el objetivo de proteger a los lactantes m&#225;s vulnerables<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">7&#8211;9</span></a>&#46; La tosferina es una enfermedad que mantiene un patr&#243;n epid&#233;mico c&#237;clico&#44; aunque en Espa&#241;a a partir de 2010 se est&#225; observando que la enfermedad se encuentra en una situaci&#243;n de epidemia sostenida<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">5</span></a>&#44; hecho que se refleja en nuestro estudio&#46; Esta situaci&#243;n coincide con la reemergencia de la tosferina observada tanto en EE&#46;&#160;UU&#46; como en otros pa&#237;ses de Europa debido a causas que a&#250;n se desconocen&#44; entre las que se postulan la p&#233;rdida de inmunidad por el paso del tiempo&#44; los cambios gen&#233;ticos en las cepas circulantes respecto a aquellas utilizadas para crear la vacuna y la falta de vacunaci&#243;n en determinados grupos de poblaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">9-13</span></a>&#46; En nuestra &#225;rea&#44; entre los a&#241;os 2003 y 2010&#44; la incidencia en menores de un a&#241;o que requirieron hospitalizaci&#243;n solo super&#243; los 100 casos en los a&#241;os 2003 y 2006&#44; con incidencias de 103&#44;9 y 204&#44;5 casos&#44; respectivamente<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">6</span></a>&#46; Desde el a&#241;o 2010 la incidencia anual de hospitalizaciones fue mayor de 130 casos por 100&#46;000&#44; con picos de incidencia de 365&#44;0 y 425&#44;0 casos en 2011 y 2015&#44; respectivamente&#46; No obstante&#44; en el 2016&#44; se observ&#243; una disminuci&#243;n de la incidencia que coincidi&#243; con la incorporaci&#243;n de la vacuna en la mujer embarazada&#46; Este hecho deber&#237;a analizarse a largo plazo&#44; para ver si esta tendencia se mantiene&#44; ya que tambi&#233;n podr&#237;a ser debida a que nos encontremos en un per&#237;odo interepid&#233;mico&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Los datos de incidencia entre pa&#237;ses son dif&#237;cilmente comparables&#44; debido a las diferencias en cuanto a la definici&#243;n de caso&#44; a las t&#233;cnicas diagn&#243;sticas empleadas y a los sistemas de notificaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">2&#44;14</span></a>&#46; Seg&#250;n datos del ECDC&#44; en 2014 la mayor tasa de notificaci&#243;n se produjo en menores de un a&#241;o&#44; con una incidencia de 51&#44;6 casos por 100&#46;000 a nivel global en Europa&#46; Espa&#241;a&#44; Lituania&#44; Pa&#237;ses Bajos&#44; Eslovenia y Suecia son los pa&#237;ses que tienen las tasas m&#225;s elevadas&#44; con m&#225;s de 100 casos por 100&#46;000 habitantes en este grupo de edad<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">15</span></a>&#46; Seg&#250;n algunos estudios&#44; la tosferina podr&#237;a estar siendo infradiagnosticada&#44; por lo que la incidencia ser&#237;a mayor&#46; La definici&#243;n de caso basado en los datos cl&#237;nicos podr&#237;a ser una causa de infradiagn&#243;stico&#44; ya que esta definici&#243;n est&#225; limitada porque los signos y s&#237;ntomas difieren con la edad&#44; con la vacunaci&#243;n previa y porque&#44; adem&#225;s&#44; a&#250;n existe un bajo nivel de sospecha cl&#237;nica en los m&#233;dicos&#44; sobre todo en adolescentes y adultos&#46; Recientemente se ha propuesto un algoritmo diagn&#243;stico basado en signos y s&#237;ntomas seg&#250;n la edad<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">16</span></a>&#46; Seg&#250;n este algoritmo&#44; se debe sospechar la tosferina en menores de 3 meses cuando presenten tos y coriza&#44; sobre todo cuando la tos aumente en frecuencia y gravedad&#44; independientemente de la duraci&#243;n y de si es o no parox&#237;stica&#44; y cuando se presenten con leucocitosis y linfocitosis&#46; En nuestro trabajo&#44; la mayor&#237;a de los pacientes presentaron tos&#44; con signos catarrales en 2&#47;3 partes de los casos&#44; y la mayor&#237;a presentaron linfocitosis&#46; Hay que destacar que los cuadros de neumon&#237;a y apnea se produjeron principalmente en menores de 3 meses&#44; como se describe en otros estudios<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">17</span></a>&#44; pero no se observaron diferencias en otros signos y s&#237;ntomas entre los 2<span class="elsevierStyleHsp" style=""></span>grupos de edad&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">La poblaci&#243;n menor de un a&#241;o es la que presenta un mayor riesgo de complicaciones&#46; Observamos una tasa de complicaciones del 15&#44;4&#37;&#44; en su mayor&#237;a&#44; neumon&#237;a&#46; La menor edad y la no vacunaci&#243;n fueron los factores de riesgo m&#225;s importantes asociados al desarrollo de complicaciones&#44; aunque ning&#250;n paciente falleci&#243;&#46; Con respecto al periodo anterior&#44; se observa una menor tasa de complicaciones &#40;23&#44;4&#37; en el per&#237;odo 2003-2007&#41;&#44; as&#237; como de fallecidos &#40;6&#44;5&#37; en el per&#237;odo 2003-2007&#41;&#46; En otros trabajos&#44; la tasa de complicaciones en este grupo de edad fue superior<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">17</span></a>&#46; Varios estudios han analizado distintas variables y han observado un mayor riesgo de muerte o enfermedad m&#225;s grave en ni&#241;os menores de 4 meses con bajo peso al nacer&#44; hiperleucocitosis &#40;&#8805;100&#46;000&#160;leucocitos&#47;&#956;L&#41;&#44; desarrollo de hipertensi&#243;n pulmonar o convulsiones&#44; y en no vacunados&#44; entre otros<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">18-20</span></a>&#44; y probablemente el tener un alto &#237;ndice de sospecha mejore el pron&#243;stico cl&#237;nico&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">En un alto porcentaje de los pacientes en los que se descart&#243; infecci&#243;n por <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span> se detect&#243; un virus&#46; El m&#225;s frecuentemente detectado fue el virus respiratorio sincitial&#44; lo que indica un solapamiento de los signos y s&#237;ntomas en este grupo de poblaci&#243;n&#44; hecho ya descrito por otros autores<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">21&#44;22</span></a>&#46; Adem&#225;s&#44; en un peque&#241;o porcentaje de pacientes se diagnostic&#243; coinfecci&#243;n con virus &#40;los rinovirus son los m&#225;s frecuentes&#41;&#44; de forma similar a otros estudios&#44; en los que los rinovirus y los coronavirus son los m&#225;s frecuentemente detectados en coinfecci&#243;n<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">22</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; en los &#250;ltimos a&#241;os se ha observado un aumento de la incidencia de tosferina en nuestro medio en menores de un a&#241;o&#44; unido a una menor tasa de complicaciones y de mortalidad si comparamos con el periodo anterior&#46; La menor edad y la no vacunaci&#243;n fueron los principales factores de riesgo asociados al desarrollo de complicaciones&#46; La incidencia y las complicaciones deber&#237;an disminuir con la vacunaci&#243;n de la mujer gestante&#44; por lo que es importante realizar estudios a largo plazo para ver la efectividad de esta medida&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflicto de intereses</span><p id="par0110" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1023180"
          "palabras" => array:5 [
            0 => "<span class="elsevierStyleItalic">Bordetella pertussis</span>"
            1 => "Tosferina"
            2 => "Tasa de incidencia"
            3 => "Coinfecci&#243;n"
            4 => "Neumon&#237;a"
          ]
        ]
      ]
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1023179"
          "palabras" => array:5 [
            0 => "<span class="elsevierStyleItalic">Bordetella pertussis</span>"
            1 => "Whooping cough"
            2 => "Incidence rate"
            3 => "Coinfection"
            4 => "Pneumonia"
          ]
        ]
      ]
    ]
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    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir el patr&#243;n epidemiol&#243;gico y cl&#237;nico de la infecci&#243;n por <span class="elsevierStyleItalic">Bordetella pertussis</span> &#40;tosferina&#41; en ni&#241;os menores de un a&#241;o hospitalizados en un hospital pedi&#225;trico de Gran Canaria&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Pacientes y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se revisaron retrospectivamente las historias cl&#237;nicas de los pacientes con diagn&#243;stico microbiol&#243;gico de infecci&#243;n por <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span> mediante reacci&#243;n en cadena de la polimerasa&#44; de enero de 2008 a diciembre de 2016&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se identificaron 110 pacientes&#44; de los cuales 105 &#40;95&#44;4&#37;&#41; fueron menores de 6 meses y el 59&#44;1&#37; eran varones&#46; La incidencia anual de hospitalizaci&#243;n se estim&#243; entre 13&#44;7 y 425&#44;0 casos por cada 100&#46;000 lactantes menores de 12 meses&#44; con 2<span class="elsevierStyleHsp" style=""></span>picos en 2011 y 2015&#46; Los familiares cercanos fueron las principales fuentes de contagio potenciales&#46; Las principales manifestaciones fueron la tos pertusoide asociada con signos catarrales&#44; cianosis y linfocitosis&#46; El 15&#44;4&#37; de los pacientes presentaron complicaciones &#40;principalmente neumon&#237;a&#41;&#44; pero la evoluci&#243;n fue favorable en todos los casos&#46; La menor edad y la no vacunaci&#243;n se asociaron con un mayor riesgo de desarrollar complicaciones &#40;<span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;0&#44;05&#41;&#46; La coinfecci&#243;n viral ocurri&#243; en el 31&#44;6&#37; de los pacientes diagnosticados de infecci&#243;n por <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span>&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La incidencia de infecci&#243;n por <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span> ha aumentado en los &#250;ltimos a&#241;os en nuestra &#225;rea&#44; con un menor desarrollo de complicaciones y con tasas de mortalidad inferiores al per&#237;odo anterior&#46; La menor edad y la no vacunaci&#243;n previa se consideran factores de riesgo para el desarrollo de complicaciones&#46; La vacunaci&#243;n en mujeres embarazadas probablemente disminuir&#225; la incidencia en el futuro&#44; sobre todo en ni&#241;os menores de 6 meses&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Pacientes y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Describe the epidemiological and clinical pattern of <span class="elsevierStyleItalic">Bordetella pertussis</span> infection &#40;whooping cough&#41; among hospitalised infants less than one year-old in a paediatric hospital in Gran Canaria&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A retrospective review of the patient hospital records was performed&#44; and recording only those with a microbiological diagnosis of pertussis infection detected using polymerase chain reaction&#44; from January 2008 to December 2016&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 110 patients were identified&#44; of which 105 &#40;95&#46;4&#37;&#41; were less than 6 months-old&#44; and 59&#46;1&#37; were males&#46; The annual incidence of hospital admissions was estimated between 13&#46;7 to 425&#46;0 cases per 100&#44;000 infants &#60;12 months old&#44; with 2<span class="elsevierStyleHsp" style=""></span>peaks in 2011 and 2015&#46; Household members were the main potential sources of infection&#46; Main clinical features were pertussis cough associated with signs of catarrh&#44; cyanosis&#44; and lymphocytosis&#46; Complications occurred in 15&#46;4&#37; of the patients &#40;mainly pneumonia&#41;&#44; but the outcome was favourable in all the cases&#46; A lower age and non-vaccination were associated with an increased risk of developing complications &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;05&#41;&#46; Viral co-infection occurred in 31&#46;6&#37; of infants diagnosed with pertussis&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The incidence of pertussis has increased in the last years in Gran Canaria&#44; with a lower development of complications and mortality rates compared with the previous period&#46; Lower age and non-vaccination status are considered risk factors for developing complications&#46; Vaccination in pregnant women will probably lead to a decline in the incidence in the future&#44; especially in infants younger than 6 months&#46;</p></span>"
        "secciones" => array:4 [
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            "identificador" => "abst0025"
            "titulo" => "Objective"
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            "identificador" => "abst0030"
            "titulo" => "Patients and methods"
          ]
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            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">El presente trabajo se ha presentado en el <span class="elsevierStyleSmallCaps">XXI</span> Congreso Nacional de la SEIMC &#40;N&#46;&#176; de comunicaci&#243;n 300&#41;&#46;</p>"
      ]
    ]
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        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
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        "figura" => array:1 [
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        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Incidencia anual de casos de tosferina por 100&#46;000 ni&#241;os menores de un a&#241;o confirmados por laboratorio &#40;2008-2016&#41;&#46;</p>"
        ]
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        "mostrarFloat" => true
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        "detalles" => array:1 [
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            "identificador" => "at1"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#8804;3 meses de edad &#40;&#37;&#41;<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#62; 3 meses de edad &#40;&#37;&#41;<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;&#37;&#41;<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>110&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Caracter&#237;sticas cl&#237;nicas</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Tos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44 &#40;97&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">109 &#40;99&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Tos pertusoide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56 &#40;86&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;71&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88 &#40;80&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Signos catarrales<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43 &#40;66&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73 &#40;66&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cianosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;53&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;48&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57 &#40;51&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>V&#243;mito postusivo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;30&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;26&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;29&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fiebre&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;12&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;17&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;14&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Apnea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;10&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;8&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;15&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;9&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Taquipnea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;4&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Polipnea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;3&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Datos de laboratorio</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Linfocitosis absoluta &#40;&#62;10&#46;000&#47;mm<span class="elsevierStyleSup">3</span>&#41; o relativa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#40;90&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41 &#40;95&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">99 &#40;92&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Leucocitosis &#40;&#62;17&#46;500&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;46&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;34&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;42&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Trombocitosis &#40;&#62;450&#46;000&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43 &#40;67&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;55&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67 &#40;62&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Cuadro de v&#237;as altas&#58; rinorrea&#44; coriza&#44; estornudos o lagrimeo&#46;</p>"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Datos de 107 pacientes &#40;97&#44;3&#37;&#41;&#46;</p>"
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          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Manifestaciones cl&#237;nicas y datos anal&#237;ticos de los 110 pacientes con infecci&#243;n por <span class="elsevierStyleItalic">B&#46; pertussis</span></p>"
        ]
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        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
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            "identificador" => "at2"
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            "rol" => "short"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">AZM&#58; azitromicina&#59; inh&#58; inhalada&#59; iv&#58; intravenosa&#59; M&#58; mujer&#59; MID&#58; miembro inferior derecho&#59; NP&#58; nutrici&#243;n parenteral&#59; <span class="elsevierStyleSmallCaps">V</span>&#58; var&#243;n&#59; VM&#58; ventilaci&#243;n mec&#225;nica&#59; VRS&#58; virus respiratorio sincitial&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Caso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Edad &#40;d&#237;as&#41;&#47;sexo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vacunaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Leucocitos por &#215;1&#46;000&#47;mm<span class="elsevierStyleSup">3</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Coinfecci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Complicaciones&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Ingreso UMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tratamiento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">103&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&#44; hiperleucocitosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; VM&#44; sedorrelajaci&#243;n&#44; exsangu&#237;neo transfusi&#243;n&#44; adrenalina inh&#44; dexametaxona iv&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; VM&#44; sedorrelajaci&#243;n&#44; NP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&#44; necrosis isqu&#233;mica de MID con amputaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; VM&#44; sedorrelajaci&#243;n&#44; NP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">-</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; VM&#44; sedorrelajaci&#243;n&#44; NP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">VM&#44; sedorrelajaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">-</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; VM&#44; sedorrelajaci&#243;n&#44; NP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 dosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; VM&#44; sedorrelajaci&#243;n&#44; NP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">VRS</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&#44; convulsiones&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; rivotril&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 10 d&#237;as&#44; ox&#237;geno&#44; NP&#44; enoxaparina&#44;<br>adrenalina inh&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sin datos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5d&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Cosxackie B</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Apnea secundaria a salvas de tos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; incorporaci&#243;n y ox&#237;geno en crisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Apnea secundaria a salvas de tos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; incorporaci&#243;n y ox&#237;geno en crisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Rinovirus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Apnea secundaria a salvas de tos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; incorporaci&#243;n y ox&#237;geno en crisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Apnea secundaria a salvas de tos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; incorporaci&#243;n y ox&#237;geno en crisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Increase of pertussis incidence in 2010 to 2012 after 12 years of low circulation in Spain"
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                            2 => "J&#46; Masa-Calles"
                            3 => "M&#46;V&#46; Mart&#237;nez de Arag&#243;n"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Pertussis across the globe&#58; Recent epidemiologic trends from 2000 to 2013"
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Tan"
                            1 => "T&#46; Dalby"
                            2 => "K&#46; Forsyth"
                            3 => "S&#46;A&#46; Halperin"
                            4 => "U&#46; Heininger"
                            5 => "D&#46; Hozbor"
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                    0 => array:2 [
                      "doi" => "10.1097/INF.0000000000000547"
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                        "tituloSerie" => "Pediatr Infect Dis J&#46;"
                        "fecha" => "2015"
                        "volumen" => "34"
                        "paginaInicial" => "222"
                        "paginaFinal" => "232"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25229271"
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                          ]
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                      ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Underdetection and underreporting of pertussis in children attended in primary health care centers&#58; Do surveillance systems requiere improvement&#63;"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "I&#46; Crespo"
                            2 => "M&#46;I&#46; Fern&#225;ndez"
                            3 => "C&#46; Valero"
                            4 => "M&#46;I&#46; &#193;lvarez"
                            5 => "P&#46; Godoy"
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                      ]
                    ]
                  ]
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                    0 => array:1 [
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                        "tituloSerie" => "Am J Infect Control&#46;"
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                      ]
                    ]
                  ]
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                0 => array:2 [
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                      "titulo" => "Trends in pertussis diagnostic testing in the United States&#44; 1990 to 2012"
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                            4 => "T&#46;A&#46; Clark"
                            5 => "S&#46;W&#46; Martin"
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                        "volumen" => "35"
                        "paginaInicial" => "39"
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                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26418242"
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                  "referenciaCompleta" => "Situaci&#243;n de la tosferina en Espa&#241;a&#44; 2005-2016&#46; Centro Nacional de Epidemiolog&#237;a&#44; Instituto de Salud Carlos III&#44; Madrid&#46; 2016 &#91;consultado 1 mayo 2017&#93;&#46; Disponible en&#58; <a id="intr0005" class="elsevierStyleInterRef" href="http://www.isciii.es/ISCIII/es/contenidos/fd-servicios-cientifico-tecnicos/fd-vigilancias-alertas/fd-enfermedades/pdf_2016/INFORME_Tos_ferina_Espana_2005-2016.pdf">http&#58;&#47;&#47;www&#46;isciii&#46;es&#47;ISCIII&#47;es&#47;contenidos&#47;fd-servicios-cientifico-tecnicos&#47;fd-vigilancias-alertas&#47;fd-enfermedades&#47;pdf&#95;2016&#47;INFORME&#95;Tos&#95;ferina&#95;Espana&#95;2005-2016&#46;pdf</a>"
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                      "titulo" => "Epidemiology and clinical study of <span class="elsevierStyleItalic">Bordetella pertussis</span> in Gran Canaria Island&#44; Spain&#44; in the period 2003-2007"
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                            2 => "R&#46; Gonz&#225;lez Jorge"
                            3 => "E&#46; Colino Gil"
                            4 => "A&#46; Bordes Ben&#237;tez"
                            5 => "M&#46;J&#46; Pena L&#243;pez"
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                      "titulo" => "Update on immunization and pregnancy&#58; Tetanus&#44; diphtheria&#44; and pertussis vaccination"
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                      "titulo" => "Tosferina en Espa&#241;a&#46; Situaci&#243;n epidemiol&#243;gica y estrategias de prevenci&#243;n y control&#46; Recomendaciones del Grupo de Trabajo de Tosferina"
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                      "autores" => array:1 [
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                          "etal" => true
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              "referencia" => array:1 [
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                      "titulo" => "Clinical definitions of pertussis&#58; Summary of a Global Pertussis Initiative roundtable meeting&#44; February 2011"
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                    0 => array:2 [
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                        "link" => array:1 [
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Risk factors associated with infant deaths from pertussis&#58; A case-control study"
                      "autores" => array:1 [
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                            2 => "K&#46; Harriman"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26082502"
                            "web" => "Medline"
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                ]
              ]
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              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Infant and maternal risk factors for pertussis-related infant mortality in the United States&#44; 1999 to 2004"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
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                            3 => "T&#46;V&#46; Murphy"
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                    ]
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                    0 => array:2 [
                      "doi" => "10.1097/INF.0b013e31818c9032"
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                        "tituloSerie" => "Pediatr Infect Dis J&#46;"
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                        "paginaInicial" => "194"
                        "paginaFinal" => "198"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19209089"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics of severe <span class="elsevierStyleItalic">Bordetella pertussis</span> infection among infants &#60;90 days of age admitted to pediatric intensive care units-Southern California&#44; september 2009- june 2011"
                      "autores" => array:1 [
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                            5 => "D&#46; Lehman"
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                    ]
                  ]
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                    0 => array:1 [
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                    ]
                  ]
                ]
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                    0 => array:2 [
                      "titulo" => "High prevalence of <span class="elsevierStyleItalic">Bordetella pertussis</span> in children under 5 years old hospitalized with acute respiratory infections in Lima"
                      "autores" => array:1 [
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26626910"
                            "web" => "Medline"
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                    0 => array:2 [
                      "titulo" => "Comparison of molecular detection methods for pertussis in children during a state-wide outbreak"
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ORIGINAL
Estudio clínico-epidemiológico de la infección por Bordetella pertussis en la isla de Gran Canaria en el período 2008-2016
Clinical-epidemiological study of Bordetella pertussis infection in the Gran Canaria island in the period, 2008-2016
Laura Iglesiasa,
Autor para correspondencia
laura.igll@hotmail.com

Autor para correspondencia.
, Antonio Casabella Pernasa, Melisa Hernández Feblesa, Elena Colino Gilb, Alicia Eisman Maravera, María José Pena Lópeza
a Servicio de Microbiología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España
b Servicio de Pediatría, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, España
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pertussis</span>&#44; analizando las variables demogr&#225;ficas&#44; antecedentes de vacunaci&#243;n&#44; fuente probable de infecci&#243;n &#40;persona con cuadro cl&#237;nico compatible con tosferina en contacto con el ni&#241;o&#41;&#44; sintomatolog&#237;a&#44; datos de laboratorio y tratamiento&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Para el an&#225;lisis estad&#237;stico de los resultados se utiliz&#243; la prueba de Mann-Whitney para comparar variables cuantitativas y la de chi cuadrado para comparar proporciones&#46; Se consider&#243; significaci&#243;n estad&#237;stica un valor de <span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;0&#44;05&#46; El estudio fue aprobado por el Comit&#233; Local de Bio&#233;tica e Investigaci&#243;n&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Epidemiolog&#237;a</span><p id="par0030" class="elsevierStylePara elsevierViewall">En 110 pacientes &#40;10&#44;6&#37;&#41; 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La tasa de incidencia anual oscil&#243; entre 13&#44;7 casos en el a&#241;o 2009 y 425&#44;0 casos en el a&#241;o 2015&#44; con 2<span class="elsevierStyleHsp" style=""></span>picos en los a&#241;os 2011 y 2015&#46; Desde el a&#241;o 2010&#44; el a&#241;o con menor incidencia de casos fue 2016&#46; Por estaciones&#44; el 33&#44;6&#37; de los casos se produjeron en verano&#44; el 29&#44;1&#37; en primavera&#44; el 19&#44;1&#37; en invierno y el 18&#44;2&#37; en oto&#241;o&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Con relaci&#243;n al estado vacunal&#44; 56 ni&#241;os &#40;50&#44;9&#37;&#41; no hab&#237;an iniciado el calendario de vacunaci&#243;n&#44; 47 &#40;42&#44;7&#37;&#41; hab&#237;an recibido una dosis&#44; 5 &#40;4&#44;5&#37;&#41; 2<span class="elsevierStyleHsp" style=""></span>dosis y 2<span class="elsevierStyleHsp" style=""></span>&#40;1&#44;8&#37;&#41; 3<span class="elsevierStyleHsp" style=""></span>dosis&#46; Solo uno de los ni&#241;os no estaba correctamente vacunado para su edad&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">En 45 pacientes &#40;40&#44;9&#37;&#41; se document&#243; la posible fuente de infecci&#243;n&#44; que fue en 44 casos &#40;97&#44;8&#37;&#41; la transmisi&#243;n familiar y en un caso fue nosocomial&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Diecisiete ni&#241;os con tosferina nacieron despu&#233;s de la incorporaci&#243;n de la vacunaci&#243;n en la gestante&#59; de estos&#44; en 5 &#40;29&#44;4&#37;&#41; la madre hab&#237;a recibido la vacuna en el tercer trimestre de embarazo &#40;una en la semana 28&#44; una en la semana 31 y en las otras 3 no consta la semana de gestaci&#243;n&#41;&#46; La edad media de los 5 ni&#241;os fue de 2&#44;8 meses &#40;rango 0-5&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Manifestaciones cl&#237;nicas</span><p id="par0065" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se recogen las caracter&#237;sticas cl&#237;nicas y las alteraciones anal&#237;ticas de los 110 pacientes&#46; El cuadro cl&#237;nico t&#237;pico se caracteriz&#243; por la presencia de tos pertusoide&#44; con signos catarrales&#44; cianosis y linfocitosis&#46; La &#250;nica diferencia con relaci&#243;n a las caracter&#237;sticas cl&#237;nicas entre los ni&#241;os mayores y menores de 3 meses fue la neumon&#237;a&#44; que se present&#243; solo en menores de 3 meses &#40;<span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;0&#44;01&#41;&#46; El tiempo medio desde el inicio de los s&#237;ntomas hasta que acudieron al Servicio de Urgencias fue de 9&#44;0&#160;&#177;&#160;5&#44;9 d&#237;as &#40;rango&#58; 1-28&#41;&#46; Ingresaron 107 pacientes &#40;97&#44;3&#37;&#41;&#44; con un tiempo medio de ingreso de 10&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;3 d&#237;as &#40;rango&#58; 0-45&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Presentaron complicaciones 17 pacientes &#40;15&#44;4&#37;&#41;&#58; 10 casos de neumon&#237;a y 7 de apnea&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se muestran las caracter&#237;sticas de los ni&#241;os que presentaron complicaciones&#58; el 82&#44;3&#37; de los ni&#241;os no hab&#237;an iniciado la vacunaci&#243;n y el resto solo hab&#237;an recibido una dosis&#46; Nueve ni&#241;os con neumon&#237;a ingresaron en la Unidad de Cuidados Intensivos&#46; Una ni&#241;a de 42 d&#237;as &#40;caso 1&#41; que ingres&#243; en dicha unidad present&#243; inicialmente un recuento de leucocitos de 27&#46;200&#47;&#956;l&#44; pero a los 13 d&#237;as del cuadro lleg&#243; a presentar una hiperleucocitosis &#40;103&#46;000 leucocitos&#47;&#956;l&#41; por lo que se le practic&#243; una exsanguineotransfusi&#243;n de doble volemia&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestran las diferencias entre los ni&#241;os que presentaron complicaciones y los que no&#46; En ella se observa que los ni&#241;os que presentaron complicaciones ten&#237;an una edad menor y&#44; en un alto porcentaje&#44; no hab&#237;a iniciado el calendario vacunal&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Todos los pacientes recibieron tratamiento desde el momento del ingreso con azitromicina &#40;10<span class="elsevierStyleHsp" style=""></span>mg&#47;kg al d&#237;a&#41; durante 5 d&#237;as &#40;salvo uno que lo recibi&#243; 10 d&#237;as&#41; y la evoluci&#243;n fue buena&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Coinfecciones con otros pat&#243;genos</span><p id="par0080" class="elsevierStylePara elsevierViewall">En 57 pacientes &#40;51&#44;8&#37;&#41; con infecci&#243;n por <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span> se investig&#243; la presencia de virus y en 18 &#40;31&#44;6&#37;&#41; se detect&#243; coinfecci&#243;n&#58; 9 con rinovirus&#44; 3<span class="elsevierStyleHsp" style=""></span>parainfluenza 3&#44; 2<span class="elsevierStyleHsp" style=""></span>virus respiratorio sincitial&#44; uno adenovirus&#44; uno virus influenza C&#44; uno citomegalovirus y uno con virus Coxsackie B&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discusi&#243;n</span><p id="par0085" class="elsevierStylePara elsevierViewall">A pesar de la amplia cobertura vacunal en la poblaci&#243;n pedi&#225;trica&#44; la tosferina sigue siendo un problema de salud p&#250;blica&#44; por lo que&#44; recientemente&#44; se introdujo la vacunaci&#243;n en el embarazo en nuestra comunidad&#44; con el objetivo de proteger a los lactantes m&#225;s vulnerables<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">7&#8211;9</span></a>&#46; La tosferina es una enfermedad que mantiene un patr&#243;n epid&#233;mico c&#237;clico&#44; aunque en Espa&#241;a a partir de 2010 se est&#225; observando que la enfermedad se encuentra en una situaci&#243;n de epidemia sostenida<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">5</span></a>&#44; hecho que se refleja en nuestro estudio&#46; Esta situaci&#243;n coincide con la reemergencia de la tosferina observada tanto en EE&#46;&#160;UU&#46; como en otros pa&#237;ses de Europa debido a causas que a&#250;n se desconocen&#44; entre las que se postulan la p&#233;rdida de inmunidad por el paso del tiempo&#44; los cambios gen&#233;ticos en las cepas circulantes respecto a aquellas utilizadas para crear la vacuna y la falta de vacunaci&#243;n en determinados grupos de poblaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">9-13</span></a>&#46; En nuestra &#225;rea&#44; entre los a&#241;os 2003 y 2010&#44; la incidencia en menores de un a&#241;o que requirieron hospitalizaci&#243;n solo super&#243; los 100 casos en los a&#241;os 2003 y 2006&#44; con incidencias de 103&#44;9 y 204&#44;5 casos&#44; respectivamente<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">6</span></a>&#46; Desde el a&#241;o 2010 la incidencia anual de hospitalizaciones fue mayor de 130 casos por 100&#46;000&#44; con picos de incidencia de 365&#44;0 y 425&#44;0 casos en 2011 y 2015&#44; respectivamente&#46; No obstante&#44; en el 2016&#44; se observ&#243; una disminuci&#243;n de la incidencia que coincidi&#243; con la incorporaci&#243;n de la vacuna en la mujer embarazada&#46; Este hecho deber&#237;a analizarse a largo plazo&#44; para ver si esta tendencia se mantiene&#44; ya que tambi&#233;n podr&#237;a ser debida a que nos encontremos en un per&#237;odo interepid&#233;mico&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Los datos de incidencia entre pa&#237;ses son dif&#237;cilmente comparables&#44; debido a las diferencias en cuanto a la definici&#243;n de caso&#44; a las t&#233;cnicas diagn&#243;sticas empleadas y a los sistemas de notificaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">2&#44;14</span></a>&#46; Seg&#250;n datos del ECDC&#44; en 2014 la mayor tasa de notificaci&#243;n se produjo en menores de un a&#241;o&#44; con una incidencia de 51&#44;6 casos por 100&#46;000 a nivel global en Europa&#46; Espa&#241;a&#44; Lituania&#44; Pa&#237;ses Bajos&#44; Eslovenia y Suecia son los pa&#237;ses que tienen las tasas m&#225;s elevadas&#44; con m&#225;s de 100 casos por 100&#46;000 habitantes en este grupo de edad<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">15</span></a>&#46; Seg&#250;n algunos estudios&#44; la tosferina podr&#237;a estar siendo infradiagnosticada&#44; por lo que la incidencia ser&#237;a mayor&#46; La definici&#243;n de caso basado en los datos cl&#237;nicos podr&#237;a ser una causa de infradiagn&#243;stico&#44; ya que esta definici&#243;n est&#225; limitada porque los signos y s&#237;ntomas difieren con la edad&#44; con la vacunaci&#243;n previa y porque&#44; adem&#225;s&#44; a&#250;n existe un bajo nivel de sospecha cl&#237;nica en los m&#233;dicos&#44; sobre todo en adolescentes y adultos&#46; Recientemente se ha propuesto un algoritmo diagn&#243;stico basado en signos y s&#237;ntomas seg&#250;n la edad<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">16</span></a>&#46; Seg&#250;n este algoritmo&#44; se debe sospechar la tosferina en menores de 3 meses cuando presenten tos y coriza&#44; sobre todo cuando la tos aumente en frecuencia y gravedad&#44; independientemente de la duraci&#243;n y de si es o no parox&#237;stica&#44; y cuando se presenten con leucocitosis y linfocitosis&#46; En nuestro trabajo&#44; la mayor&#237;a de los pacientes presentaron tos&#44; con signos catarrales en 2&#47;3 partes de los casos&#44; y la mayor&#237;a presentaron linfocitosis&#46; Hay que destacar que los cuadros de neumon&#237;a y apnea se produjeron principalmente en menores de 3 meses&#44; como se describe en otros estudios<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">17</span></a>&#44; pero no se observaron diferencias en otros signos y s&#237;ntomas entre los 2<span class="elsevierStyleHsp" style=""></span>grupos de edad&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">La poblaci&#243;n menor de un a&#241;o es la que presenta un mayor riesgo de complicaciones&#46; Observamos una tasa de complicaciones del 15&#44;4&#37;&#44; en su mayor&#237;a&#44; neumon&#237;a&#46; La menor edad y la no vacunaci&#243;n fueron los factores de riesgo m&#225;s importantes asociados al desarrollo de complicaciones&#44; aunque ning&#250;n paciente falleci&#243;&#46; Con respecto al periodo anterior&#44; se observa una menor tasa de complicaciones &#40;23&#44;4&#37; en el per&#237;odo 2003-2007&#41;&#44; as&#237; como de fallecidos &#40;6&#44;5&#37; en el per&#237;odo 2003-2007&#41;&#46; En otros trabajos&#44; la tasa de complicaciones en este grupo de edad fue superior<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">17</span></a>&#46; Varios estudios han analizado distintas variables y han observado un mayor riesgo de muerte o enfermedad m&#225;s grave en ni&#241;os menores de 4 meses con bajo peso al nacer&#44; hiperleucocitosis &#40;&#8805;100&#46;000&#160;leucocitos&#47;&#956;L&#41;&#44; desarrollo de hipertensi&#243;n pulmonar o convulsiones&#44; y en no vacunados&#44; entre otros<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">18-20</span></a>&#44; y probablemente el tener un alto &#237;ndice de sospecha mejore el pron&#243;stico cl&#237;nico&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">En un alto porcentaje de los pacientes en los que se descart&#243; infecci&#243;n por <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span> se detect&#243; un virus&#46; El m&#225;s frecuentemente detectado fue el virus respiratorio sincitial&#44; lo que indica un solapamiento de los signos y s&#237;ntomas en este grupo de poblaci&#243;n&#44; hecho ya descrito por otros autores<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">21&#44;22</span></a>&#46; Adem&#225;s&#44; en un peque&#241;o porcentaje de pacientes se diagnostic&#243; coinfecci&#243;n con virus &#40;los rinovirus son los m&#225;s frecuentes&#41;&#44; de forma similar a otros estudios&#44; en los que los rinovirus y los coronavirus son los m&#225;s frecuentemente detectados en coinfecci&#243;n<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">22</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; en los &#250;ltimos a&#241;os se ha observado un aumento de la incidencia de tosferina en nuestro medio en menores de un a&#241;o&#44; unido a una menor tasa de complicaciones y de mortalidad si comparamos con el periodo anterior&#46; La menor edad y la no vacunaci&#243;n fueron los principales factores de riesgo asociados al desarrollo de complicaciones&#46; La incidencia y las complicaciones deber&#237;an disminuir con la vacunaci&#243;n de la mujer gestante&#44; por lo que es importante realizar estudios a largo plazo para ver la efectividad de esta medida&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflicto de intereses</span><p id="par0110" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir el patr&#243;n epidemiol&#243;gico y cl&#237;nico de la infecci&#243;n por <span class="elsevierStyleItalic">Bordetella pertussis</span> &#40;tosferina&#41; en ni&#241;os menores de un a&#241;o hospitalizados en un hospital pedi&#225;trico de Gran Canaria&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Pacientes y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se revisaron retrospectivamente las historias cl&#237;nicas de los pacientes con diagn&#243;stico microbiol&#243;gico de infecci&#243;n por <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span> mediante reacci&#243;n en cadena de la polimerasa&#44; de enero de 2008 a diciembre de 2016&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se identificaron 110 pacientes&#44; de los cuales 105 &#40;95&#44;4&#37;&#41; fueron menores de 6 meses y el 59&#44;1&#37; eran varones&#46; La incidencia anual de hospitalizaci&#243;n se estim&#243; entre 13&#44;7 y 425&#44;0 casos por cada 100&#46;000 lactantes menores de 12 meses&#44; con 2<span class="elsevierStyleHsp" style=""></span>picos en 2011 y 2015&#46; Los familiares cercanos fueron las principales fuentes de contagio potenciales&#46; Las principales manifestaciones fueron la tos pertusoide asociada con signos catarrales&#44; cianosis y linfocitosis&#46; El 15&#44;4&#37; de los pacientes presentaron complicaciones &#40;principalmente neumon&#237;a&#41;&#44; pero la evoluci&#243;n fue favorable en todos los casos&#46; La menor edad y la no vacunaci&#243;n se asociaron con un mayor riesgo de desarrollar complicaciones &#40;<span class="elsevierStyleItalic">p</span>&#160;&#60;&#160;0&#44;05&#41;&#46; La coinfecci&#243;n viral ocurri&#243; en el 31&#44;6&#37; de los pacientes diagnosticados de infecci&#243;n por <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span>&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La incidencia de infecci&#243;n por <span class="elsevierStyleItalic">B&#46;&#160;pertussis</span> ha aumentado en los &#250;ltimos a&#241;os en nuestra &#225;rea&#44; con un menor desarrollo de complicaciones y con tasas de mortalidad inferiores al per&#237;odo anterior&#46; La menor edad y la no vacunaci&#243;n previa se consideran factores de riesgo para el desarrollo de complicaciones&#46; La vacunaci&#243;n en mujeres embarazadas probablemente disminuir&#225; la incidencia en el futuro&#44; sobre todo en ni&#241;os menores de 6 meses&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Pacientes y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Describe the epidemiological and clinical pattern of <span class="elsevierStyleItalic">Bordetella pertussis</span> infection &#40;whooping cough&#41; among hospitalised infants less than one year-old in a paediatric hospital in Gran Canaria&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A retrospective review of the patient hospital records was performed&#44; and recording only those with a microbiological diagnosis of pertussis infection detected using polymerase chain reaction&#44; from January 2008 to December 2016&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 110 patients were identified&#44; of which 105 &#40;95&#46;4&#37;&#41; were less than 6 months-old&#44; and 59&#46;1&#37; were males&#46; The annual incidence of hospital admissions was estimated between 13&#46;7 to 425&#46;0 cases per 100&#44;000 infants &#60;12 months old&#44; with 2<span class="elsevierStyleHsp" style=""></span>peaks in 2011 and 2015&#46; Household members were the main potential sources of infection&#46; Main clinical features were pertussis cough associated with signs of catarrh&#44; cyanosis&#44; and lymphocytosis&#46; Complications occurred in 15&#46;4&#37; of the patients &#40;mainly pneumonia&#41;&#44; but the outcome was favourable in all the cases&#46; A lower age and non-vaccination were associated with an increased risk of developing complications &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;05&#41;&#46; Viral co-infection occurred in 31&#46;6&#37; of infants diagnosed with pertussis&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The incidence of pertussis has increased in the last years in Gran Canaria&#44; with a lower development of complications and mortality rates compared with the previous period&#46; Lower age and non-vaccination status are considered risk factors for developing complications&#46; Vaccination in pregnant women will probably lead to a decline in the incidence in the future&#44; especially in infants younger than 6 months&#46;</p></span>"
        "secciones" => array:4 [
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            "identificador" => "abst0025"
            "titulo" => "Objective"
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            "identificador" => "abst0030"
            "titulo" => "Patients and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">El presente trabajo se ha presentado en el <span class="elsevierStyleSmallCaps">XXI</span> Congreso Nacional de la SEIMC &#40;N&#46;&#176; de comunicaci&#243;n 300&#41;&#46;</p>"
      ]
    ]
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        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
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        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Incidencia anual de casos de tosferina por 100&#46;000 ni&#241;os menores de un a&#241;o confirmados por laboratorio &#40;2008-2016&#41;&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#8804;3 meses de edad &#40;&#37;&#41;<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#62; 3 meses de edad &#40;&#37;&#41;<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;&#37;&#41;<br>n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>110&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Caracter&#237;sticas cl&#237;nicas</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Tos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44 &#40;97&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">109 &#40;99&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Tos pertusoide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56 &#40;86&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;71&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88 &#40;80&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Signos catarrales<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43 &#40;66&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;66&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73 &#40;66&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cianosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35 &#40;53&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;48&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">57 &#40;51&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>V&#243;mito postusivo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;30&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12 &#40;26&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;29&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fiebre&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;12&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;17&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;14&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Apnea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;10&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;4&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;8&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;15&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;9&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Taquipnea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;4&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;2&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Polipnea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;3&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Datos de laboratorio</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Linfocitosis absoluta &#40;&#62;10&#46;000&#47;mm<span class="elsevierStyleSup">3</span>&#41; o relativa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">58 &#40;90&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41 &#40;95&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">99 &#40;92&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Leucocitosis &#40;&#62;17&#46;500&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;46&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15 &#40;34&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;42&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Trombocitosis &#40;&#62;450&#46;000&#47;mm<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">43 &#40;67&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;55&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67 &#40;62&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Cuadro de v&#237;as altas&#58; rinorrea&#44; coriza&#44; estornudos o lagrimeo&#46;</p>"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Datos de 107 pacientes &#40;97&#44;3&#37;&#41;&#46;</p>"
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          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Manifestaciones cl&#237;nicas y datos anal&#237;ticos de los 110 pacientes con infecci&#243;n por <span class="elsevierStyleItalic">B&#46; pertussis</span></p>"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">AZM&#58; azitromicina&#59; inh&#58; inhalada&#59; iv&#58; intravenosa&#59; M&#58; mujer&#59; MID&#58; miembro inferior derecho&#59; NP&#58; nutrici&#243;n parenteral&#59; <span class="elsevierStyleSmallCaps">V</span>&#58; var&#243;n&#59; VM&#58; ventilaci&#243;n mec&#225;nica&#59; VRS&#58; virus respiratorio sincitial&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Caso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Edad &#40;d&#237;as&#41;&#47;sexo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vacunaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Leucocitos por &#215;1&#46;000&#47;mm<span class="elsevierStyleSup">3</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Coinfecci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Complicaciones&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Ingreso UMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tratamiento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">103&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&#44; hiperleucocitosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; VM&#44; sedorrelajaci&#243;n&#44; exsangu&#237;neo transfusi&#243;n&#44; adrenalina inh&#44; dexametaxona iv&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; VM&#44; sedorrelajaci&#243;n&#44; NP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&#44; necrosis isqu&#233;mica de MID con amputaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; VM&#44; sedorrelajaci&#243;n&#44; NP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">-</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; VM&#44; sedorrelajaci&#243;n&#44; NP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">53&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">VM&#44; sedorrelajaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">-</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; VM&#44; sedorrelajaci&#243;n&#44; NP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">65&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 dosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; VM&#44; sedorrelajaci&#243;n&#44; NP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">VRS</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&#44; convulsiones&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; rivotril&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 10 d&#237;as&#44; ox&#237;geno&#44; NP&#44; enoxaparina&#44;<br>adrenalina inh&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sin datos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5d&#237;as&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Cosxackie B</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Apnea secundaria a salvas de tos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; incorporaci&#243;n y ox&#237;geno en crisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">28&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Apnea secundaria a salvas de tos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; incorporaci&#243;n y ox&#237;geno en crisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Rinovirus</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Apnea secundaria a salvas de tos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; incorporaci&#243;n y ox&#237;geno en crisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Apnea secundaria a salvas de tos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AZM 5<span class="elsevierStyleHsp" style=""></span>d&#237;as&#44; incorporaci&#243;n y ox&#237;geno en crisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">69&#47;<span class="elsevierStyleSmallCaps">V</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Increase of pertussis incidence in 2010 to 2012 after 12 years of low circulation in Spain"
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                      "titulo" => "Pertussis across the globe&#58; Recent epidemiologic trends from 2000 to 2013"
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                            2 => "K&#46; Forsyth"
                            3 => "S&#46;A&#46; Halperin"
                            4 => "U&#46; Heininger"
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                    0 => array:2 [
                      "doi" => "10.1097/INF.0000000000000547"
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                        "volumen" => "34"
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                        "paginaFinal" => "232"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25229271"
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                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Underdetection and underreporting of pertussis in children attended in primary health care centers&#58; Do surveillance systems requiere improvement&#63;"
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                        0 => array:2 [
                          "etal" => true
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                            3 => "C&#46; Valero"
                            4 => "M&#46;I&#46; &#193;lvarez"
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                      ]
                    ]
                  ]
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                    0 => array:1 [
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                        "tituloSerie" => "Am J Infect Control&#46;"
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                      ]
                    ]
                  ]
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                0 => array:2 [
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                      "titulo" => "Trends in pertussis diagnostic testing in the United States&#44; 1990 to 2012"
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                            4 => "T&#46;A&#46; Clark"
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                        "volumen" => "35"
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                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26418242"
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                  "referenciaCompleta" => "Situaci&#243;n de la tosferina en Espa&#241;a&#44; 2005-2016&#46; Centro Nacional de Epidemiolog&#237;a&#44; Instituto de Salud Carlos III&#44; Madrid&#46; 2016 &#91;consultado 1 mayo 2017&#93;&#46; Disponible en&#58; <a id="intr0005" class="elsevierStyleInterRef" href="http://www.isciii.es/ISCIII/es/contenidos/fd-servicios-cientifico-tecnicos/fd-vigilancias-alertas/fd-enfermedades/pdf_2016/INFORME_Tos_ferina_Espana_2005-2016.pdf">http&#58;&#47;&#47;www&#46;isciii&#46;es&#47;ISCIII&#47;es&#47;contenidos&#47;fd-servicios-cientifico-tecnicos&#47;fd-vigilancias-alertas&#47;fd-enfermedades&#47;pdf&#95;2016&#47;INFORME&#95;Tos&#95;ferina&#95;Espana&#95;2005-2016&#46;pdf</a>"
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                      "titulo" => "Epidemiology and clinical study of <span class="elsevierStyleItalic">Bordetella pertussis</span> in Gran Canaria Island&#44; Spain&#44; in the period 2003-2007"
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                            4 => "A&#46; Bordes Ben&#237;tez"
                            5 => "M&#46;J&#46; Pena L&#243;pez"
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                    0 => array:2 [
                      "titulo" => "Epidemic pertussis in 2012&#58; The resurgence of a vaccine-preventable disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
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                    0 => array:2 [
                      "doi" => "10.1056/NEJMp1209051"
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                        "tituloSerie" => "N Engl J Med&#46;"
                        "fecha" => "2012"
                        "volumen" => "367"
                        "paginaInicial" => "785"
                        "paginaFinal" => "787"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22894554"
                            "web" => "Medline"
                          ]
                        ]
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                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0170"
              "etiqueta" => "12"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effectiveness of pertussis vaccination and duration of immunity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;L&#46; Schwartz"
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                            3 => "M&#46;A&#46; Campitelli"
                            4 => "F&#46;B&#46; Jamieson"
                            5 => "A&#46; Marchand-Austin"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:2 [
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                        "tituloSerie" => "CMAJ&#46;"
                        "fecha" => "2016"
                        "volumen" => "188"
                        "paginaInicial" => "399"
                        "paginaFinal" => "406"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26783336"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0175"
              "etiqueta" => "13"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Analysis of <span class="elsevierStyleItalic">Bordetella pertussis</span> clinical isolates circulating in European countries during the period 1998-2012"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Van Gent"
                            1 => "C&#46;J&#46; Heuvelman"
                            2 => "H&#46;G&#46; van der Heide"
                            3 => "H&#46;O&#46; Hallander"
                            4 => "A&#46; Advani"
                            5 => "N&#46; Guiso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10096-014-2297-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Clin Microbiol Infect Dis&#46;"
                        "fecha" => "2015"
                        "volumen" => "34"
                        "paginaInicial" => "821"
                        "paginaFinal" => "830"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25527446"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
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              "etiqueta" => "14"
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                0 => array:3 [
                  "comentario" => "pii&#61;20239"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High heterogeneity in methods used for the laboratory confirmation of pertussis diagnosis among European countries&#44; 2010&#58; Integration of epidemiological and laboratory surveillance must include standardisation of methodologies and quality assurance"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "on behalf of the European Bordetela Expert Group"
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Q&#46; He"
                            1 => "A&#46;M&#46; Barkoff"
                            2 => "J&#46; Mertsola"
                            3 => "S&#46; Glismann"
                            4 => "S&#46; Bacci"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Euro Surveill&#46;"
                        "fecha" => "2012"
                        "volumen" => "17"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "15"
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                0 => array:1 [
                  "referenciaCompleta" => "Annual Epidemiological Report 2016&#58; Pertussis&#46; European Centre for Disease Prevention and Control&#44; 2016 &#91;consultado 1 mayo 2017&#93;&#46; Disponible en&#58; <a id="intr0010" class="elsevierStyleInterRef" href="http://ecdc.europa.eu/en/healthtopics/Pertussis/Pages/Annual-epidemiological-report-2016.aspx">http&#58;&#47;&#47;ecdc&#46;europa&#46;eu&#47;en&#47;healthtopics&#47;Pertussis&#47;Pages&#47;Annual-epidemiological-report-2016&#46;aspx</a>"
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Clinical definitions of pertussis&#58; Summary of a Global Pertussis Initiative roundtable meeting&#44; February 2011"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            3 => "K&#46;D&#46; Forsyth"
                            4 => "U&#46; Thisyakorn"
                            5 => "D&#46; Greenberg"
                          ]
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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                        "tituloSerie" => "Clin Infect Dis&#46;"
                        "fecha" => "2012"
                        "volumen" => "54"
                        "paginaInicial" => "1756"
                        "paginaFinal" => "1764"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22431797"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0195"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Detection of <span class="elsevierStyleItalic">Bordetella pertussis</span> using a PCR test in infants younger than one year old hospitalized with whooping cough in five Peruvian hospitals"
                      "autores" => array:1 [
                        0 => array:2 [
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                            3 => "V&#46; Petrozzi-Helasvuo"
                            4 => "V&#46; Casabaona-Ore"
                            5 => "I&#46; Reyes"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:2 [
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                        "tituloSerie" => "Int J Infect Dis&#46;"
                        "fecha" => "2015"
                        "volumen" => "41"
                        "paginaInicial" => "36"
                        "paginaFinal" => "41"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26523641"
                            "web" => "Medline"
                          ]
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                      ]
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                  ]
                ]
              ]
            ]
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              "etiqueta" => "18"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Risk factors associated with infant deaths from pertussis&#58; A case-control study"
                      "autores" => array:1 [
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                          "etal" => true
                          "autores" => array:6 [
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                            2 => "K&#46; Harriman"
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                            4 => "J&#46; Gornbein"
                            5 => "S&#46;J&#46; Hammer"
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                        "tituloSerie" => "Clin Infect Dis&#46;"
                        "fecha" => "2015"
                        "volumen" => "61"
                        "paginaInicial" => "1099"
                        "paginaFinal" => "1106"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26082502"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Infant and maternal risk factors for pertussis-related infant mortality in the United States&#44; 1999 to 2004"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46;L&#46; Haberling"
                            1 => "R&#46;C&#46; Holman"
                            2 => "C&#46;D&#46; Paddock"
                            3 => "T&#46;V&#46; Murphy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/INF.0b013e31818c9032"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Infect Dis J&#46;"
                        "fecha" => "2009"
                        "volumen" => "28"
                        "paginaInicial" => "194"
                        "paginaFinal" => "198"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19209089"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0210"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics of severe <span class="elsevierStyleItalic">Bordetella pertussis</span> infection among infants &#60;90 days of age admitted to pediatric intensive care units-Southern California&#44; september 2009- june 2011"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
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                            0 => "E&#46;L&#46; Murray"
                            1 => "D&#46; Nieves"
                            2 => "J&#46;S&#46; Bradley"
                            3 => "J&#46; Gargas"
                            4 => "W&#46;H&#46; Mason"
                            5 => "D&#46; Lehman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Pediatr Infect Dis J&#46;"
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                        "volumen" => "2"
                        "paginaInicial" => "1"
                        "paginaFinal" => "6"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0215"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High prevalence of <span class="elsevierStyleItalic">Bordetella pertussis</span> in children under 5 years old hospitalized with acute respiratory infections in Lima"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
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                            1 => "S&#46; Bendez&#250;-Medina"
                            2 => "A&#46; Herrera-Alzamora"
                            3 => "P&#46; Weilg"
                            4 => "M&#46;J&#46; Pons"
                            5 => "M&#46;A&#46; Aguilar-Luis"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12879-015-1287-z"
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                        "tituloSerie" => "Peru&#46; BMC Infect Dis&#46;"
                        "fecha" => "2015"
                        "volumen" => "15"
                        "paginaInicial" => "554"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26626910"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0220"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of molecular detection methods for pertussis in children during a state-wide outbreak"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "X&#46; Qin"
                            1 => "D&#46;M&#46; Zerr"
                            2 => "M&#46;P&#46; Kronman"
                            3 => "A&#46;L&#46; Adler"
                            4 => "J&#46;E&#46; Berry"
                            5 => "S&#46; Rich"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12941-016-0142-4"
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Clin Microbiol Antimicrob&#46;"
                        "fecha" => "2016"
                        "volumen" => "15"
                        "paginaInicial" => "28"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27121506"
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                ]
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