BACKGROUND Gestational diabetes mellitus(GDM)has become increasingly prevalent globally.Glycemic control in pregnant women with GDM has a critical role in neonatal complications.AIM To analyze the early neonatal compl...BACKGROUND Gestational diabetes mellitus(GDM)has become increasingly prevalent globally.Glycemic control in pregnant women with GDM has a critical role in neonatal complications.AIM To analyze the early neonatal complications in GDM,and examine the effect of blood glucose control level on neonatal infection.METHODS The clinical data of 236 pregnant women with GDM and 240 healthy pregnant women and newborns during from March 2020 to December 2021 the same period were retrospectively analyzed,and the early complications in newborns in the two groups were compared.The patients were divided into the conforming glycemic control group(CGC group)and the non-conforming glycemic control group(NCGC group)based on whether glycemic control in the pregnant women with GDM conformed to standards.Baseline data,immune function,infectionrelated markers,and infection rates in neonates were compared between the two groups.RESULTS The incidence of neonatal complications in the 236 neonates in the GDM group was significantly higher than that in the control group(P<0.05).Pregnant women with GDM in the NCGC group(n=178)had significantly higher fasting plasma glucose,2 h postprandial blood glucose and glycated hemoglobin A1C levels than those in the CGC group(n=58)(P<0.05).There were no differences in baseline data between the two groups(P>0.05).Additionally,the NCGC group had significantly decreased peripheral blood CD3^(+),CD4^(+),CD8^(+)T cell ratios,CD4/CD8 ratios and immunoglobulin G in neonates compared with the CGC group(P<0.05),while white blood cells,serum procalcitonin and C-reactive protein levels increased significantly.The neonatal infection rate was also significantly increased in the NCGC group(P<0.05).CONCLUSION The risk of neonatal complications increased in pregnant women with GDM.Poor glycemic control decreased neonatal immune function,and increased the incidence of neonatal infections.展开更多
Background: Late Neonatal Bacterial Infection (LNNBI) is a clinical and biological manifestations related to penetration and growth of specific causative bacteria in bloodstream occurring on the 4<sup>th</sup...Background: Late Neonatal Bacterial Infection (LNNBI) is a clinical and biological manifestations related to penetration and growth of specific causative bacteria in bloodstream occurring on the 4<sup>th</sup>-28<sup>th</sup> day of life. LNNBI still represents an important cause of mortality and morbidity among infants. Objectives: To determine the frequency of late bacterial infections in newborns, to describe the clinical and biological profiles and to identify the main responsible germs. Methods: Descriptive study data collection, conducted over a period of 10 months at the Brazzaville Teaching Hospital, of interest to newborns admitted from the 4<sup>th</sup> day of life for suspicion of neonatal infection, and those admitted for any other pathology and having presented an infection 48 hours after hospitalization, and in whom a bacterial culture and/or an inflammatory assessment confirmed or suspected infection. Results: During the study period, 1682 newborns were hospitalized, and 86 were hospitalized for a late neonatal bacterial infection, i.e. a frequency of 5.1%. There were 67 (77.9%) community infections and 19 (22.1%) nosocomial infections. The frequency of nosocomial infection was 1.1%. The main signs were fever in 65 cases (75.6%), and respiratory distress in 37 cases (43%). The most frequent localizations were bacteremia 32 (37.2%), pulmonary 21 (24.4%), digestive and meningeal in 11 cases (12.8%) each. The most common germ Klebsiella in 10 (50%) newborns was resistant to the usual antibiotics. The evolution was favorable in 71 cases (82.5%), and death occurred in 12 cases (14%). Conclusion: Late neonatal bacterial infection is common. The main responsible germs are gram-negative bacilli, in particular Klebsiella multi-resistant.展开更多
<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Urinary tract infection (UTI) is common in pregnancy...<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Urinary tract infection (UTI) is common in pregnancy and accounts for a high burden of maternal and perinatal morbidity/mortality and </span><span style="font-family:Verdana;">health expenditure. The burden of this condition has been understudied in Came</span><span style="font-family:Verdana;">roon. We aimed to determine the uropathogens of urinary tract infection in pregnancy, and the maternal-fetal outcomes of UTI at the Douala Re</span><span><span style="font-family:Verdana;">ferral Hospital. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We conducted an analytic matched case-control study </span></span><span style="font-family:Verdana;">of 206 pregnant wom</span><span style="font-family:Verdana;">en with evid</span><span style="font-family:Verdana;">ence of uri</span><span style="font-family:Verdana;">nary tract infectio</span><span style="font-family:Verdana;">n (103 cases)</span><span style="font-family:Verdana;"> an</span><span style="font-family:Verdana;">d </span><span style="font-family:Verdana;">those without (103 controls) who underwent antenatal care and gave birth at </span><span style="font-family:Verdana;">the DRH from January 2019 to April 2019. Socio-demographic, laboratory and</span> <span style="font-family:Verdana;">maternal-fetal outcome data were collected using a pre-tested structured questionnai</span><span style="font-family:Verdana;">re and analyzed with SPSS version 23. Statistical significance was set at </span><span><span style="font-family:Verdana;">p < 0.05. </span><b><span style="font-family:Verdana;">Results:</span></b> <i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> (51.5%), </span><i><span style="font-family:Verdana;">Proteus mirabilis</span></i><span style="font-family:Verdana;"> (15.5%), </span><i><span style="font-family:Verdana;">S</span></i></span><i><span style="font-family:Verdana;">taphylococcus aureus</span></i><span style="font-family:Verdana;"> (11.7%) and </span><i><span style="font-family:Verdana;">Klebsiella sp</span></i><span style="font-family:Verdana;">. (6.8%) were the predominant uropathogens of UTI. Maternal outcomes of UTI were puerperal pyelonephritis (AOR 3.1;95% CI: 1.11 - 3.55, p = 0.0023), preterm labor (AOR 4.4;95% CI: 1.0 - 2.7, p = 0.008) and preterm birth (AOR 4.6;95% CI 1.9 - 22.9, p = 0.05). Furthermore, low birth weight (AOR 2.1;95% CI: 0.8 - 5.6, p = 0.05), neonatal infection (AOR 13;95% CI: 0.9 - 191.6, p = 0.04) and neonatal intensive care unit admission (AOR 2.5;95% CI: 1.7 - 3.6, p = 0.003) were fetal outcomes of UTI. </span><b><span style="font-family:Verdana;">Conclusion:</span></b> <i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> was the main uropathogenic </span><span style="font-family:Verdana;">agent of UTI during pregnancy. Maternal outcomes of UTI were puerperal pyel</span><span style="font-family:Verdana;">onephritis, preterm labor and delivery while fetal outcomes include: low-birth </span><span style="font-family:Verdana;">weight, neonatal infection and neonatal intensive care admission. Prompt diagnosis of this condition is the cornerstone to avoid adverse outcomes.</span></span></span></span>展开更多
Objectives: This study aimed to investigate the effect of COVID-19 on fetal well-being and perinatal outcomes. Methods: Pregnant women with documented COVID-19 infection who visited the antenatal care clinic of El Sha...Objectives: This study aimed to investigate the effect of COVID-19 on fetal well-being and perinatal outcomes. Methods: Pregnant women with documented COVID-19 infection who visited the antenatal care clinic of El Shatby Maternity Hospital, Alexandria, Egypt, from May 2020 to May 2021 were selected and classified into three groups according to the illness severity: mild, moderate, and severe. Fetal well-being was examined using the umbilical and cerebral Doppler and nonstress test (NST). The estimated fetal weight and amniotic fluid volume were also evaluated. After delivery, the neonates were evaluated through Apgar scoring at 1 and 5 min, cord blood samples, and neonatal nasopharyngeal swabs. Results: Abnormal umbilical and cerebral Doppler findings, abnormal NST results, higher incidence of cesarean section (CS) and emergency CS, and poor perinatal outcomes were observed in severe cases. Moderate and mild maternal infections had neither an adverse perinatal outcome nor an effect on the mode of delivery. Conclusion: Severe COVID-19 infection can affect the perinatal outcome.展开更多
<strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Early bacterial neonatal infection (INBP) or maternofetal infe...<strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Early bacterial neonatal infection (INBP) or maternofetal infection (early neonatal sepsis) remains a concern of the pediatrician due to diagnostic difficulties and its increased morbidity and mortality. No study has been done in Mali on the profile of newborns admitted for INBP with positive CRP, hence the initiation of this work with the aim of studying the epidemiological, biological and bacteriological profile of newborns with a bacterial maternal-fetal infection. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> Longitudinal study descriptive (from 27 June to 3 September 2016) which concerned all newborns aged from 0 to 72 hours of life hospitalized for confirmed early bacterial neonatal infection with a positive C</span></span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">reactive protein (CRP) in the neonatal department of the CHU Gabriel Touré. INBP was defined by the presence of maternal and neonatal infectious risk factors, positivity of CRP with a germ in the blood culture. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> During the study period we included 244 newborns for probable maternofetal infection and who benefited from the CRP assay, 43 had a positive CRP, </span><i><span style="font-family:Verdana;">i</span></i></span><i><span style="font-family:Verdana;">.</span></i><i><span style="font-family:Verdana;">e</span></i><i><span style="font-family:Verdana;">.</span></i><span style="font-family:Verdana;"> a frequency of 17.62%. The sex ratio was 2.30. The majority had a low birth weight (<2500</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">g) in 69.8% of cases. Mothers were aged 18 to 35 in 93%. The majority were out of school (43.8%) and housewives in 74.4%. The main reasons for consultations were prematurity and/or low birth weight, respiratory distress and neonatal distress, </span><i><span style="font-family:Verdana;">i</span></i></span><i><span style="font-family:Verdana;">.</span></i><i><span style="font-family:Verdana;">e</span></i><i><span style="font-family:Verdana;">.</span></i><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">46.5%, 25.6% and 11.6% respectively. Among the 43 newborns with a positive CRP, the blood culture returned p</span><span><span style="font-family:Verdana;">ositive in 79.1% (n = 34). We deplore 2 deaths (4.7%). The main bacteria were gram-positive cocci (</span><i><span style="font-family:Verdana;">Staphylococcus aureus</span></i><span style="font-family:Verdana;"> 53.01% and </span><i><span style="font-family:Verdana;">Streptococccus agalactiae</span></i><span style="font-family:Verdana;"> 4.10%), gram-negative bacilli (GNB) type </span><i><span style="font-family:Verdana;">Enterobacteriaceae (Klebsiella pneumoniae</span></i><span style="font-family:Verdana;"> 11.25% and </span><i><span style="font-family:Verdana;">E. coli</span></i><span style="font-family:Verdana;"> at 5.70%) and non-fermentativ</span></span><span style="font-family:Verdana;">e </span><span style="font-family:Verdana;">GNB</span><span style="font-family:Verdana;">s </span><span><span style="font-family:Verdana;">(</span><i><span style="font-family:Verdana;">Pseudomonas aeruginosa</span></i><span style="font-family:Verdana;"> 2.80% and </span><i><span style="font-family:Verdana;">Acinetobacter baumannii</span></i><span style="font-family:Verdana;"> complex </span></span><span style="font-family:Verdana;">2.24%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Maternal-fetal infection is a hospital pathology frequently encountered in the neonatal period. Its clinical presentation is dominated by respiratory distress, neurological disorders and low birth weight.</span></span>展开更多
In 2022-2023,a global outbreak of Mpox was reported especially in nonendemic countries.We report the first laboratory-confirmed neonatal case of Mpox infection complicated by bronchopneumonia in Sri Lanka.
<strong>Introduction:</strong> <span style="font-family:Verdana;">Respiratory pathologies are top listed amongst neonatal morbidities.</span><span style="font-family:"&qu...<strong>Introduction:</strong> <span style="font-family:Verdana;">Respiratory pathologies are top listed amongst neonatal morbidities.</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Our objective was to describe the clinical features, causes and treatment of respiratory distress (RD) in full and post term neonates in a tertiary health center in Yaoundé, the Essos Hospital Centre (EHC). </span><b><span style="font-family:Verdana;">Patients and Method: </span></b><span style="font-family:Verdana;">This was a retrospective study. Full/post term neonates with RD from January 2017-December 2018 were included.</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Main parameters: incidence of RD, etiologies, risk factors for severity and mortality. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We included 186 neonates among 2312 newborn babies. The RD prevalence rate was 8%. Sex ratio of 2.15 was favoring male, median gestational age of 38 weeks. Clinical signs of RD were dominated by a Silverman score above 4/10 in 64%.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">Main etiologies were pneumonia (44%),</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">followed by transient ta</span><span style="font-family:Verdana;">chypnea</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">(35.4).</span><span style="font-family:""> </span><span style="font-family:Verdana;">Perinatal asphyxia</span><span style="font-family:""> </span><span style="font-family:Verdana;">(OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">9.412, P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.005) and cyanosis</span><span style="font-family:""> </span><span style="font-family:Verdana;">(O</span><span style="font-family:Verdana;">R</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">6.509;P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001)</span><span style="font-family:""> </span><span style="font-family:Verdana;">were worsening RD, while caesarian section was protective</span><span style="font-family:""> </span><span style="font-family:Verdana;">(OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.412;P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.050).</span><span style="font-family:""> </span><span style="font-family:Verdana;">Mortality rate</span><span style="font-family:""> </span><span style="font-family:Verdana;">(MR) was 10.4%.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Therapeutic measures</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">briefly consisted in oxygen therapy for 98.9% of patients and probabilistic antibiotic therapy. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Neonatal pneumonia was the preeminent etiology of RD in this population;the MR was high.</span></span>展开更多
Aim:Immune challenge during early and late neonatal periods can induce robust alterations in physiological and behavioral functions,resulting in greater risk for the development of neuropsychiatric disorders,such as a...Aim:Immune challenge during early and late neonatal periods can induce robust alterations in physiological and behavioral functions,resulting in greater risk for the development of neuropsychiatric disorders,such as anxiety and depression,later in life.In addition,previous studies concluded that increasing age correlates with increased depression behaviors in humans and rodents.This study aimed to investigate for the first time whether immune challenge with a viral mimic,synthetic double-stranded ribonucleic acid(Poly I:C)during different neonatal periods can differently affect depression-related behaviors in adolescent and adult mice.Methods:Male C57BL/6 mice were treated with either saline or Poly I:C(1 mg/kg and 4 mg/kg)on postnatal days(PND)3-5(early neonatal phase)or PND 14-16(late neonatal phase),and then subjected to behavioral tests,including tail suspension test and forced swimming test,during adolescence(PND 35 or 40)and adulthood(PND 85 or 90).Results:The results demonstrated that early neonatal immune activation increases depression-related behaviors in both adolescent and adult mice,but late neonatal immune activation only increases depression in adult mice.In other words,these findings indicated that the nature of the offspring’s neuropathology can depend on the severity of the insult,the pup’s age at the time of the insult,and offspring age at the time of behavioral testing.Conclusion:These findings suggest that dose and timing of neonatal insult and offspring age may be important factors for evaluating neuropsychiatric disorders in adults who experienced early life infection.展开更多
Background Antibiotics,a common strategy used for neonatal infection,show consistent effect on the gut microbiota of neonates.Supplementation with probiotics has become increasingly popular in mitigating the loss of t...Background Antibiotics,a common strategy used for neonatal infection,show consistent effect on the gut microbiota of neonates.Supplementation with probiotics has become increasingly popular in mitigating the loss of the gut microbiota.However,no clear consensus recommending the use of probiotics in the infection of neonates currently exists.This study examined the effects of probiotics on the gut microbiota of infectious neonates when used concurrently with or during the recovery period following antibiotic therapy.Methods Fifty-five full-term neonates diagnosed with neonatal infections were divided into the following groups:NI(no intervention,antibiotic therapy only),PCA(probiotics used concurrently with antibiotics),and PAA(probiotics used after antibiotics).The NI group received antibiotic treatment(piperacillin–tazobactam)for 1 week and the PCA group received antibiotic treatment together with probiotics(Bifidobacterium longum,Lactobacillus acidophilus,and Enterococcus faecalis)for 1 week.The PAA group received antibiotic treatment for 1 week followed by probiotics for 1 week.Fecal samples were collected at four time nodes:newborn,1 week,2 weeks,and 42 days after birth.The composition of the gut microbiota was determined by the high-throughput sequencing of 16S rRNA amplicons.Results Antibiotic exposure was found to dramatically alter gut microbiota,with a significant decrease of Bifidobacterium and Lactobacillus.The use of probiotics did not restore the overall diversity of the gut microbiota.However,using probiotics simultaneously with the antibiotics was found to be beneficial for the gut microbiota as compared to delaying the use of probiotics to follow treatment with antibiotics,particularly in promoting the abundance of Bifidobacterium.Conclusions These results suggest that the early use of probiotics may have a potential ability to remodel the gut microbiota during recovery from antibiotic treatment.However,further study is required to fully understand the long-term effects including the clinical benefits.展开更多
文摘BACKGROUND Gestational diabetes mellitus(GDM)has become increasingly prevalent globally.Glycemic control in pregnant women with GDM has a critical role in neonatal complications.AIM To analyze the early neonatal complications in GDM,and examine the effect of blood glucose control level on neonatal infection.METHODS The clinical data of 236 pregnant women with GDM and 240 healthy pregnant women and newborns during from March 2020 to December 2021 the same period were retrospectively analyzed,and the early complications in newborns in the two groups were compared.The patients were divided into the conforming glycemic control group(CGC group)and the non-conforming glycemic control group(NCGC group)based on whether glycemic control in the pregnant women with GDM conformed to standards.Baseline data,immune function,infectionrelated markers,and infection rates in neonates were compared between the two groups.RESULTS The incidence of neonatal complications in the 236 neonates in the GDM group was significantly higher than that in the control group(P<0.05).Pregnant women with GDM in the NCGC group(n=178)had significantly higher fasting plasma glucose,2 h postprandial blood glucose and glycated hemoglobin A1C levels than those in the CGC group(n=58)(P<0.05).There were no differences in baseline data between the two groups(P>0.05).Additionally,the NCGC group had significantly decreased peripheral blood CD3^(+),CD4^(+),CD8^(+)T cell ratios,CD4/CD8 ratios and immunoglobulin G in neonates compared with the CGC group(P<0.05),while white blood cells,serum procalcitonin and C-reactive protein levels increased significantly.The neonatal infection rate was also significantly increased in the NCGC group(P<0.05).CONCLUSION The risk of neonatal complications increased in pregnant women with GDM.Poor glycemic control decreased neonatal immune function,and increased the incidence of neonatal infections.
文摘Background: Late Neonatal Bacterial Infection (LNNBI) is a clinical and biological manifestations related to penetration and growth of specific causative bacteria in bloodstream occurring on the 4<sup>th</sup>-28<sup>th</sup> day of life. LNNBI still represents an important cause of mortality and morbidity among infants. Objectives: To determine the frequency of late bacterial infections in newborns, to describe the clinical and biological profiles and to identify the main responsible germs. Methods: Descriptive study data collection, conducted over a period of 10 months at the Brazzaville Teaching Hospital, of interest to newborns admitted from the 4<sup>th</sup> day of life for suspicion of neonatal infection, and those admitted for any other pathology and having presented an infection 48 hours after hospitalization, and in whom a bacterial culture and/or an inflammatory assessment confirmed or suspected infection. Results: During the study period, 1682 newborns were hospitalized, and 86 were hospitalized for a late neonatal bacterial infection, i.e. a frequency of 5.1%. There were 67 (77.9%) community infections and 19 (22.1%) nosocomial infections. The frequency of nosocomial infection was 1.1%. The main signs were fever in 65 cases (75.6%), and respiratory distress in 37 cases (43%). The most frequent localizations were bacteremia 32 (37.2%), pulmonary 21 (24.4%), digestive and meningeal in 11 cases (12.8%) each. The most common germ Klebsiella in 10 (50%) newborns was resistant to the usual antibiotics. The evolution was favorable in 71 cases (82.5%), and death occurred in 12 cases (14%). Conclusion: Late neonatal bacterial infection is common. The main responsible germs are gram-negative bacilli, in particular Klebsiella multi-resistant.
文摘<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Urinary tract infection (UTI) is common in pregnancy and accounts for a high burden of maternal and perinatal morbidity/mortality and </span><span style="font-family:Verdana;">health expenditure. The burden of this condition has been understudied in Came</span><span style="font-family:Verdana;">roon. We aimed to determine the uropathogens of urinary tract infection in pregnancy, and the maternal-fetal outcomes of UTI at the Douala Re</span><span><span style="font-family:Verdana;">ferral Hospital. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We conducted an analytic matched case-control study </span></span><span style="font-family:Verdana;">of 206 pregnant wom</span><span style="font-family:Verdana;">en with evid</span><span style="font-family:Verdana;">ence of uri</span><span style="font-family:Verdana;">nary tract infectio</span><span style="font-family:Verdana;">n (103 cases)</span><span style="font-family:Verdana;"> an</span><span style="font-family:Verdana;">d </span><span style="font-family:Verdana;">those without (103 controls) who underwent antenatal care and gave birth at </span><span style="font-family:Verdana;">the DRH from January 2019 to April 2019. Socio-demographic, laboratory and</span> <span style="font-family:Verdana;">maternal-fetal outcome data were collected using a pre-tested structured questionnai</span><span style="font-family:Verdana;">re and analyzed with SPSS version 23. Statistical significance was set at </span><span><span style="font-family:Verdana;">p < 0.05. </span><b><span style="font-family:Verdana;">Results:</span></b> <i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> (51.5%), </span><i><span style="font-family:Verdana;">Proteus mirabilis</span></i><span style="font-family:Verdana;"> (15.5%), </span><i><span style="font-family:Verdana;">S</span></i></span><i><span style="font-family:Verdana;">taphylococcus aureus</span></i><span style="font-family:Verdana;"> (11.7%) and </span><i><span style="font-family:Verdana;">Klebsiella sp</span></i><span style="font-family:Verdana;">. (6.8%) were the predominant uropathogens of UTI. Maternal outcomes of UTI were puerperal pyelonephritis (AOR 3.1;95% CI: 1.11 - 3.55, p = 0.0023), preterm labor (AOR 4.4;95% CI: 1.0 - 2.7, p = 0.008) and preterm birth (AOR 4.6;95% CI 1.9 - 22.9, p = 0.05). Furthermore, low birth weight (AOR 2.1;95% CI: 0.8 - 5.6, p = 0.05), neonatal infection (AOR 13;95% CI: 0.9 - 191.6, p = 0.04) and neonatal intensive care unit admission (AOR 2.5;95% CI: 1.7 - 3.6, p = 0.003) were fetal outcomes of UTI. </span><b><span style="font-family:Verdana;">Conclusion:</span></b> <i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> was the main uropathogenic </span><span style="font-family:Verdana;">agent of UTI during pregnancy. Maternal outcomes of UTI were puerperal pyel</span><span style="font-family:Verdana;">onephritis, preterm labor and delivery while fetal outcomes include: low-birth </span><span style="font-family:Verdana;">weight, neonatal infection and neonatal intensive care admission. Prompt diagnosis of this condition is the cornerstone to avoid adverse outcomes.</span></span></span></span>
文摘Objectives: This study aimed to investigate the effect of COVID-19 on fetal well-being and perinatal outcomes. Methods: Pregnant women with documented COVID-19 infection who visited the antenatal care clinic of El Shatby Maternity Hospital, Alexandria, Egypt, from May 2020 to May 2021 were selected and classified into three groups according to the illness severity: mild, moderate, and severe. Fetal well-being was examined using the umbilical and cerebral Doppler and nonstress test (NST). The estimated fetal weight and amniotic fluid volume were also evaluated. After delivery, the neonates were evaluated through Apgar scoring at 1 and 5 min, cord blood samples, and neonatal nasopharyngeal swabs. Results: Abnormal umbilical and cerebral Doppler findings, abnormal NST results, higher incidence of cesarean section (CS) and emergency CS, and poor perinatal outcomes were observed in severe cases. Moderate and mild maternal infections had neither an adverse perinatal outcome nor an effect on the mode of delivery. Conclusion: Severe COVID-19 infection can affect the perinatal outcome.
文摘<strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Early bacterial neonatal infection (INBP) or maternofetal infection (early neonatal sepsis) remains a concern of the pediatrician due to diagnostic difficulties and its increased morbidity and mortality. No study has been done in Mali on the profile of newborns admitted for INBP with positive CRP, hence the initiation of this work with the aim of studying the epidemiological, biological and bacteriological profile of newborns with a bacterial maternal-fetal infection. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> Longitudinal study descriptive (from 27 June to 3 September 2016) which concerned all newborns aged from 0 to 72 hours of life hospitalized for confirmed early bacterial neonatal infection with a positive C</span></span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">reactive protein (CRP) in the neonatal department of the CHU Gabriel Touré. INBP was defined by the presence of maternal and neonatal infectious risk factors, positivity of CRP with a germ in the blood culture. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> During the study period we included 244 newborns for probable maternofetal infection and who benefited from the CRP assay, 43 had a positive CRP, </span><i><span style="font-family:Verdana;">i</span></i></span><i><span style="font-family:Verdana;">.</span></i><i><span style="font-family:Verdana;">e</span></i><i><span style="font-family:Verdana;">.</span></i><span style="font-family:Verdana;"> a frequency of 17.62%. The sex ratio was 2.30. The majority had a low birth weight (<2500</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">g) in 69.8% of cases. Mothers were aged 18 to 35 in 93%. The majority were out of school (43.8%) and housewives in 74.4%. The main reasons for consultations were prematurity and/or low birth weight, respiratory distress and neonatal distress, </span><i><span style="font-family:Verdana;">i</span></i></span><i><span style="font-family:Verdana;">.</span></i><i><span style="font-family:Verdana;">e</span></i><i><span style="font-family:Verdana;">.</span></i><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">46.5%, 25.6% and 11.6% respectively. Among the 43 newborns with a positive CRP, the blood culture returned p</span><span><span style="font-family:Verdana;">ositive in 79.1% (n = 34). We deplore 2 deaths (4.7%). The main bacteria were gram-positive cocci (</span><i><span style="font-family:Verdana;">Staphylococcus aureus</span></i><span style="font-family:Verdana;"> 53.01% and </span><i><span style="font-family:Verdana;">Streptococccus agalactiae</span></i><span style="font-family:Verdana;"> 4.10%), gram-negative bacilli (GNB) type </span><i><span style="font-family:Verdana;">Enterobacteriaceae (Klebsiella pneumoniae</span></i><span style="font-family:Verdana;"> 11.25% and </span><i><span style="font-family:Verdana;">E. coli</span></i><span style="font-family:Verdana;"> at 5.70%) and non-fermentativ</span></span><span style="font-family:Verdana;">e </span><span style="font-family:Verdana;">GNB</span><span style="font-family:Verdana;">s </span><span><span style="font-family:Verdana;">(</span><i><span style="font-family:Verdana;">Pseudomonas aeruginosa</span></i><span style="font-family:Verdana;"> 2.80% and </span><i><span style="font-family:Verdana;">Acinetobacter baumannii</span></i><span style="font-family:Verdana;"> complex </span></span><span style="font-family:Verdana;">2.24%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Maternal-fetal infection is a hospital pathology frequently encountered in the neonatal period. Its clinical presentation is dominated by respiratory distress, neurological disorders and low birth weight.</span></span>
文摘In 2022-2023,a global outbreak of Mpox was reported especially in nonendemic countries.We report the first laboratory-confirmed neonatal case of Mpox infection complicated by bronchopneumonia in Sri Lanka.
文摘<strong>Introduction:</strong> <span style="font-family:Verdana;">Respiratory pathologies are top listed amongst neonatal morbidities.</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Our objective was to describe the clinical features, causes and treatment of respiratory distress (RD) in full and post term neonates in a tertiary health center in Yaoundé, the Essos Hospital Centre (EHC). </span><b><span style="font-family:Verdana;">Patients and Method: </span></b><span style="font-family:Verdana;">This was a retrospective study. Full/post term neonates with RD from January 2017-December 2018 were included.</span></span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">Main parameters: incidence of RD, etiologies, risk factors for severity and mortality. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We included 186 neonates among 2312 newborn babies. The RD prevalence rate was 8%. Sex ratio of 2.15 was favoring male, median gestational age of 38 weeks. Clinical signs of RD were dominated by a Silverman score above 4/10 in 64%.</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">Main etiologies were pneumonia (44%),</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">followed by transient ta</span><span style="font-family:Verdana;">chypnea</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">(35.4).</span><span style="font-family:""> </span><span style="font-family:Verdana;">Perinatal asphyxia</span><span style="font-family:""> </span><span style="font-family:Verdana;">(OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">9.412, P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.005) and cyanosis</span><span style="font-family:""> </span><span style="font-family:Verdana;">(O</span><span style="font-family:Verdana;">R</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">6.509;P</span><span style="font-family:""> </span><span style="font-family:Verdana;"><</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.001)</span><span style="font-family:""> </span><span style="font-family:Verdana;">were worsening RD, while caesarian section was protective</span><span style="font-family:""> </span><span style="font-family:Verdana;">(OR</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.412;P</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">0.050).</span><span style="font-family:""> </span><span style="font-family:Verdana;">Mortality rate</span><span style="font-family:""> </span><span style="font-family:Verdana;">(MR) was 10.4%.</span><span style="font-family:""> </span><span style="font-family:Verdana;">Therapeutic measures</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">briefly consisted in oxygen therapy for 98.9% of patients and probabilistic antibiotic therapy. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Neonatal pneumonia was the preeminent etiology of RD in this population;the MR was high.</span></span>
文摘Aim:Immune challenge during early and late neonatal periods can induce robust alterations in physiological and behavioral functions,resulting in greater risk for the development of neuropsychiatric disorders,such as anxiety and depression,later in life.In addition,previous studies concluded that increasing age correlates with increased depression behaviors in humans and rodents.This study aimed to investigate for the first time whether immune challenge with a viral mimic,synthetic double-stranded ribonucleic acid(Poly I:C)during different neonatal periods can differently affect depression-related behaviors in adolescent and adult mice.Methods:Male C57BL/6 mice were treated with either saline or Poly I:C(1 mg/kg and 4 mg/kg)on postnatal days(PND)3-5(early neonatal phase)or PND 14-16(late neonatal phase),and then subjected to behavioral tests,including tail suspension test and forced swimming test,during adolescence(PND 35 or 40)and adulthood(PND 85 or 90).Results:The results demonstrated that early neonatal immune activation increases depression-related behaviors in both adolescent and adult mice,but late neonatal immune activation only increases depression in adult mice.In other words,these findings indicated that the nature of the offspring’s neuropathology can depend on the severity of the insult,the pup’s age at the time of the insult,and offspring age at the time of behavioral testing.Conclusion:These findings suggest that dose and timing of neonatal insult and offspring age may be important factors for evaluating neuropsychiatric disorders in adults who experienced early life infection.
基金This work was supported by grants from the National Natural Science Foundation of China(Nos.81230057,81200264,81372615,and 81472262)the Emerging Cutting-Edge Technology Joint Research Projects of Shanghai(No.SHDC12012106)the Tongji University Subject Pilot Program(No.162385).
文摘Background Antibiotics,a common strategy used for neonatal infection,show consistent effect on the gut microbiota of neonates.Supplementation with probiotics has become increasingly popular in mitigating the loss of the gut microbiota.However,no clear consensus recommending the use of probiotics in the infection of neonates currently exists.This study examined the effects of probiotics on the gut microbiota of infectious neonates when used concurrently with or during the recovery period following antibiotic therapy.Methods Fifty-five full-term neonates diagnosed with neonatal infections were divided into the following groups:NI(no intervention,antibiotic therapy only),PCA(probiotics used concurrently with antibiotics),and PAA(probiotics used after antibiotics).The NI group received antibiotic treatment(piperacillin–tazobactam)for 1 week and the PCA group received antibiotic treatment together with probiotics(Bifidobacterium longum,Lactobacillus acidophilus,and Enterococcus faecalis)for 1 week.The PAA group received antibiotic treatment for 1 week followed by probiotics for 1 week.Fecal samples were collected at four time nodes:newborn,1 week,2 weeks,and 42 days after birth.The composition of the gut microbiota was determined by the high-throughput sequencing of 16S rRNA amplicons.Results Antibiotic exposure was found to dramatically alter gut microbiota,with a significant decrease of Bifidobacterium and Lactobacillus.The use of probiotics did not restore the overall diversity of the gut microbiota.However,using probiotics simultaneously with the antibiotics was found to be beneficial for the gut microbiota as compared to delaying the use of probiotics to follow treatment with antibiotics,particularly in promoting the abundance of Bifidobacterium.Conclusions These results suggest that the early use of probiotics may have a potential ability to remodel the gut microbiota during recovery from antibiotic treatment.However,further study is required to fully understand the long-term effects including the clinical benefits.
