Microorganismos causales más comunes y factores de riesgo según la clasificación de las infecciones neonatales / Most common causal microorganisms and risk factors based on the classification of neonatal infections

Una manera para lograr más efectividad en la decisión terapéutica en recién nacidos que cursan con infecciones, es tener conocimiento del microorganismo causal más común, según el tipo de infección por la cual cursa el paciente. Por ello el médico debe estar familiarizado con el mapa microbiológico de la institución donde trabaja y estar actualizado en el espectro de microorganismos habituales que informa la literatura, así como aquellos emergentes y reemergentes. Se revisa el estado actual de reportes de frecuencia de los microorganismos causales en recién nacidos con infecciones, tomados de la literatura médica nacional e internacional con el propósito de orientar al médico de asistencia del posible microorganismo causal más probable en base a la clínica del paciente y además, a tomar la clasificación de las infecciones como herramienta que aporta una guía de los agentes que afectan con más frecuencia al paciente recién nacido, y los factores de riesgo asociados. Se concluye que es factible y beneficioso este enfoque que le permite al médico asistencial ser más efectivo en la decisión del tratamiento a seguir. Es su deber estar familiarizado con el mapa microbiológico de la institución donde trabaja y estar actualizado en el espectro de microorganismos habituales que informa la literatura, así como aquellos emergentes y reemergentes(AU)

One way to achieve more effectiveness in therapeutic decisions related to newborns with infections is to be aware of the most common causal microorganism, depending on the type of infection the patient is suffering. Therefore, the physician should be familiar with the microbiological map of the institution where he/she works and be updated in the spectrum of common microorganisms reported by the literature, as well as those emerging and re-emerging. The current status of frequency reports of causal microorganisms in newborns with infections, taken from national and international literature, is reviewed to guide the assistance physician on the most likely possible causal microorganism based on the patient's clinic and also to use the classification of infections as a tool that provides guidance on the agents that most often affect the newborn patients, and associated risk factors. It is concluded that this approach that allows the assistance physician to be more effective in the decision of treatment to follow is feasible and beneficial. It is the physician's duty to be familiar with the microbiological map of the institution where he/she works and be updated on the spectrum of common microorganisms reported by the literature, as well as those emerging and re-emerging(AU)

A study of pattern of neonatal infections, socio-demographic correlates; clinical manifestations and bacteriological profile of neonatal infections

Background: In the newborns one of the leading causes of deaths and disease is septicemia. Classical clinical features are absent which poses a challenge for early diagnosis. Hence to prevent the deaths and diseases it is essential to go for early diagnosis and early treatment. Objective of this study pattern of neonatal infections, socio-demographic correlates; clinical manifestations and bacteriological profile of neonatal infections.Methods: A hospital based follow up study was carried out among total of 140 study subjects with age less than 28 days of life were studied over a period of one year. All these subjects were suspected to have neonatal septicaemia. Detailed history, thorough clinical examination was carried out. Samples were sent for culture and sensitivity. Subjects were followed till the outcome.Results: Among 2.02% was the incidence of the neonatal septicemia. Females were less affected than the males. Late onset septicemia was less common. Chest retraction was the most common clinical manifestation. Culture positivity rate was 44.29%. Gram-negative organisms were detected in 20 cases (64.5%). Case fatality rate was 17.14%. 41 babies (58.6%) affected by septicemia belonged to low socio economic status. 63 babies (90%) were diagnosed to have septicemia, 3 babies (4.28%) were affected by Meningitis, 2 babies were affected by pneumonia. 49 babies (50%) Belonged to Hindu both in case and control group,12 babies (42.9%) belonged to Buddhist in case group, 16 babies in control group.Conclusions: Males were more susceptible compared to the female babies as well those with higher birth weight. Late onset septicemia was less common.

Absceso parotídeo y mastitis por Staphylococcus aureus resistente a Meticillina en un neonato / Parotid abscess and mastitis by Methicillin- resistant Staphylococcus aureus in a newborn

Introducción: La parotiditis supurativa aguda se presenta con poca frecuencia en el período neonatal. Objetivo: Aportar un nuevo caso de parotiditis supurativa aguda por Staphylococcus aureus resistente a la Meticillina. Presentación del caso: El presente caso tiene la particularidad de que presentó foco de infección inicial (impétigo y conjuntamente mastitis bilateral), en el que se demostró el mismo microorganismo causal de la infección: Staphylococcus aureus resistente a la Meticillina. La mastitis bilateral evolucionó hacia la formación de absceso. En la literatura revisada solo se encontraron tres publicaciones que tratan de neonatos con un foco inicial de infección en sitios diferentes de la parotiditis. Estos aspectos fueron los que motivaron la presentación del caso. Conclusiones: Staphylococcus aureus resistente a la Meticillina ha emergido en los últimos años como agente causal de parotiditis supurativa aguda, que puede diseminarse hacia otro foco infeccioso, habitualmente se logra la curación con tratamiento antibiótico ajustado al agente causal, concretamente con Vancomicina, aunque puede requerir también tratamiento quirúrgico si ocurre abscedación(AU)

Introduction: Acute suppurative parotitis occurs infrequently in the neonatal period. Objective: To provide information of a new case of acute suppurative parotitis caused by Methicillin- resistant Staphylococcus aureus. Case presentation: The present case has the particularity that the patient presented a source of initial infection (impetigo and jointly bilateral mastitis), in which the same causal microorganism of the infection was found: Methicillin resistant Staphylococcus aureus. Bilateral mastitis evolved to the formation of abscess. In the literature reviewed, there were only 3 publications on neonates who presented an initial source of infection in sites different from parotitis. These aspects are those that motivated the presentation of this case. Conclusions: Methicillin resistant Staphylococcus aureus has emerged in the last years as a causal agent of acute suppurative parotitis that can lead to dissemination of another source of infection. Normally, the cure is achieved with antibiotic treatment adjusted to the causal microorganism, specifically with Vancomycin; although it can require surgical treatment if abscesses occurs(AU)

Diagnóstico tardio de citomegalovirose em recémnascido pré-termo, por carência de triagem no período gestacional: uma realidade do Brasil - relato de caso / Late diagnosis of cytomegalovirus in a preterm newborn due to lack of screening in the gestational period: a Brazilian reality - Case Report

O citomegalovírus pertence à família do Herpes vírus, e está presente na maior parte da população. A citomegalovirose no período neonatal pode estar associada à transmissão intra-útero por via transplacentária, ou ainda, perinatal. No caso apresentado, destaca-se a demora no diagnóstico e na efetivação da conduta terapêutica visto que, no Brasil, o rastreamento de infecção por citomegalovírus em gestante não faz parte da rotina de pré-natal. O diagnóstico da citomegalovirose neonatal é obtido por meio da realização da cultura do vírus na urina entre o terceiro e o quinto dia de vida, ou ainda, pela realização da Reação em Cadeia de Polimerase. No relato de caso, o tratamento utilizado para a citomegalovirose baseou-se no uso de Ganciclovir (500 mg/10ml por via endovenosa durante três semanas). A dificuldade de estabelecer um diagnóstico precoce da citomegalovirose neonatal ainda representa um dos principais desafios para se alcançar um melhor prognóstico da doença.

Cytomegalovirus belongs to the Herpes virus family, and is present in most of the population. Cytomegalovirus in the neonatal period may be associated with intra-uterine transmission by transplacental or perinatal transmission. In the case report, the emphasizes in delay of the diagnosis and the implementation of therapeutic management since, in Brazil, screening for cytomegalovirus infection in pregnant women is not part of the prenatal routine. The diagnosis of neonatal cytomegalovirus is obtained through the culture of the virus in the urine between the third and fifth day of life, or through the using of Polymerase Chain Reaction. In the case report the treatment used for cytomegalovirus was based on the use of Ganciclovir (500 mg / 10 ml intravenously for three weeks). The difficulty of establishing an early diagnosis of neonatal cytomegalovirus is still one of the main challenges to achieve a better prognosis of the disease.

Sialadenitis submandibular supurada aguda neonatal. Reportes de la literatura, periodo 1950-2015 / Neonatal acute suppurative submandibular sialadenitis. Literature reports from 1950-2015

Resumen: Introducción: La infección de la glándula salivar submandibular es poco común, por lo que la sialadenitis submandibular supurativa aguda neonatal no coincidente con parotiditis se considera una entidad de rara presentación. El objetivo de esta revisión fue verificar si ha habido cambios en los aspectos clínicos y microbiológicos de esta infección desde sus primeras descripciones. Métodos: Se realizó una revisión de la literatura internacional en distintas fuentes de información desde los primeros reportes y hasta abril del 2016, para tratar de recopilar todos los casos publicados con esta infección hasta la fecha actual. Resultados: El total de pacientes reportados en esta revisión fue de 39 neonatos en 30 artículos. Las publicaciones provinieron fundamentalmente de los Estados Unidos y Europa, mientras que en América Latina solo ha sido declarado un caso en Cuba. Se describen distintos aspectos clínicos de presentación y evolución de esta infección en los pacientes reportados. Conclusiones: La sialadenitis submandibular supurada aguda neonatal es una infección poco común que presenta características clínicas similares a través de los años. Como característica microbiológica, esta infección es habitualmente ocasionada por Staphylococcus aureus aunque en los últimos 16 años involucra algunos Staphylococcus aureus resistentes a meticilina. Por lo general, evoluciona de manera favorable con tratamiento temprano y apropiado.

Abstract: Background: Submandibular salivary gland infections are uncommon. For this reason, neonatal acute suppurative submandibular sialadenitis non-coincident with parotitis is considered as a rare entity. The aim of this work was to verify if there have been changes in the clinical and microbiological aspects of this infection from its first descriptions. Methods: A review of the international literature from different sources was performed from the earliest reports until April, 2016, in order to collect all the cases reported with this infection up to the present date. Results: We found 39 neonate patients reported in 30 articles for this review. Most articles came from the United States of America and Europe, whereas in Latin America there was only one case declared in Cuba. Some of the clinical aspects of the presentation and evolution of this infection in the reported patients are described. Conclusions: Neonatal acute suppurative submandibular sialadenitis is an uncommon infection that presents similar clinical features through the years. As microbiological feature, this infection is usually caused by Staphylococcus aureus, although some methicillin-resistant Staphylococcus aureus have been implicated during the last 16 years. In general, it presents a satisfactory evolution with an early and appropriate antibiotic treatment.

Sialadenitis submandibular supurativa aguda neonatal / Acute neonatal suppurative submandibular sialadenitis

En la literatura cubana no existen reportes de pacientes neonatales con sialadenitis submandibular supurativa aguda. Con el objetivo de presentar y describir las características clínicas de un recién nacido con sialadenitis submandibular supurativa aguda, se expone el caso de un neonato con diagnóstico de sialadenitis submandibular supurativa aguda, quien ingresó en el servicio de Neonatología del Hospital Pediátrico Universitario “Juan Manuel Márquez”, y es el único que se ha presentado en 22 años (desde 1992 hasta 2013) en esta institución, con esa entidad. La sialadenitis submandibular supurativa aguda neonatal es de presentación rara, no es común en el recién nacido a término como nuestro caso, se distingue fácilmente por los signos inflamatorios focales, además de secreción purulenta en la boca a través del conducto de Wharton, y es el Staphylococcus aureus el microorganismo causal habitual de esta infección.

There is not a single report in the Cuban scientific literature on neonates with acute suppurative submandibular sialadenitis. With the objective of presenting and describing the clinical characteristics of a newborn with this disease, this report presented the case of a newborn diagnosed with acute suppurative submandibular sialadenitis, which was admitted to the neonatology service of “Juan Manuel Marquez” university pediatric hospital and is the only one seen at this institution in 22 years (1992 through 2013). Acute neonatal suppurative submandibular sialadenitis is rare in term newborn as it occurred here; it can be easily recognized by focal inflammatory signs in addition to purulent secretion in the mouth through Wharton's duct. Staphylococcus aureus is the regular causative agent of this infection.

Serie de 8 casos de parotiditis supurada aguda neonatal / Eight cases of acute neonatal suppurative parotitis

La parotiditis supurada aguda es una infección poco frecuente en la práctica del pediatra y neonatólogo. El objetivo es mostrar nuestra experiencia en la atención de serie de casos con parotiditis supurada aguda en el período neonatal, y describir sus características de presentación. Se presentan los hallazgos clínicos en 8 pacientes con parotiditis supurativa neonatal, quienes estuvieron ingresados en el Servicio de Neonatología del Hospital Pediátrico Universitario "Juan Manuel Márquez", durante el período de 22 años (desde el año 1992 hasta el año 2013), y se contrasta con los reportes publicados en la literatura internacional. Las características de presentación de la parotiditis aguda supurada de nuestros casos concuerdan con la literatura revisada en muchos aspectos, y se demuestra que es, además, una infección poco frecuente en el período neonatal. Es la primera publicación sobre esta entidad en neonatos en Cuba, y la mayor serie de casos en el ámbito latinoamericano.

Acute suppurative parotitis is a rare infection in the pediatric and neonatological practice. This case presentation showed our experience in the care of a case series affected by acute suppurative parotitis in their neonatal period and described the characteristics of their presentation. The clinical findings obtained in 8 patients with neonatal suppurative parotitis, who had been admitted to the neonatology service of ¨Juan Manuel Marquez¨university pediatric hospital in the period of 1992 to 2013, were presented and compared with the reports from the international literature. The presentation characteristics of the disease in our cases agreed with those of the reviewed literature in many aspects, and it was proved that this illness is rate in the neonatal period. This is the first report published about this disease in neonates in Cuba and the highest number of cases in the Latin American context.

Increased CD5 + B Cells in Neonatal Infections / 대한면역학회지

PURPOSE: CD5+ B (B1) cell is a subpopulation of B cells and CD5+ B cells constitute a large fraction of B cells in neonates. CD5 B cells are closely related with autoimmune diseases but the roles and functions in neonates are still unknown. The quantitative changes of CD5+ B cells in neonatal infections were examined to investigate the involvement of CDS+ B cells in neonatal immune reaction to general immunologic stimuli such as infections. Methods: Ten normal neonates and eight neonates with acute febrile diseases were studied. Venous blood was drawn and mononuclear cells were separated by Ficoll-Hypaque. Half was double-stained with FITC-conjugated anti-CD5 and PE-conjugated anti-CD19, and another half with FITC-conjugated anti-CD4 and PE-conjugated anti-CD8. Stained samples were analyzed using fluorescent-activated cell sortor. ...continue...