Relevancia de los enterovirus en la meningitis neonatal / Relevance of enteroviruses in neonatal meningitis

Introducción: Las infecciones por enterovirus (EV) constituyen las infecciones más frecuentes en el periodo neonatal y provocan en muchos casos el ingreso hospitalario del recién nacido (RN). El objetivo del estudio es conocer la incidencia de los EV en la etiología de las meningitis neonatales y definir qué características clínicas presentan los RN con meningitis por EV. Material y método: Estudio observacional retrospectivo de cohortes. Incluye 91 RN con meningitis y edad gestacional mayor de 34 semanas (SG) atendidos en nuestro centro durante un periodo de 16 años. Resultados: El porcentaje de RN con meningitis por EV fue superior al de RN con meningitis bacteriana y representó el 78% (n=71). La mitad de los RN con infección por EV presentó antecedentes de ambiente epidémico entre sus cuidadores. La fiebre apareció en el 96% de los casos como signo clínico y, en general, las alteraciones del sensorio representaron las principales alteraciones neurológicas. Un 71,4% de los pacientes con infección por EV recibió antibióticos. La detección de EV en muestras de LCR mostró una elevada sensibilidad para el diagnóstico de meningitis por EV. Los tipos de EV más frecuentemente implicados fueron echovirus 11, coxsackievirus B5, echovirus 18, 25 y 7. Conclusiones: Los resultados de esta serie muestran que la infección por enterovirus es una causa común de meningitis neonatal. Estos datos subrayan la importancia de realizar pruebas de detección rápida de EV en lactantes con sospecha de meningitis. Ello permite obtener un diagnóstico precoz y reducir el tratamiento antibiótico, el tiempo de hospitalización y los costes relacionados.(AU)

Introduction: Enterovirus (EV) infections are the most frequent infections in the neonatal period and in many cases lead to hospital admission of the newborn (NB). The aim of this study was to determine the incidence of EV in the etiology of neonatal meningitis and to define the clinical characteristics of newborns with EV meningitis. Material and method: Retrospective observational cohort study. Including 91 NBs with meningitis and gestational age greater than 34 weeks gestational age (GA) attended in our center over a period of 16 years. Results: The percentage of NBs with EV meningitis was higher than that of NBs with bacterial meningitis (BM) and accounted for 78% (n=71). Half of the NBs with EV infection had a history of epidemic environment among their caregivers. Fever was present in 96% of cases as a clinical sign and, in general, sensory disturbances represented the main neurological alterations. Antibiotics (ATB) were given to 71.4% of patients with EV infection. Detection of EV in CSF samples showed a high sensitivity for the diagnosis of EV meningitis. The most frequently implicated EV types were echovirus 11, coxsackievirus B5, echovirus 18, 25 and 7. Conclusions: The results of this series show that enterovirus infection is a common cause of neonatal meningitis. These data underline the importance of rapid EV testing of infants with suspected meningitis. This allows early diagnosis and reduces antibiotic treatment, hospitalization time and related costs.(AU)

Relevance of enteroviruses in neonatal meningitis.

INTRODUCTION: Enterovirus (EV) infections are the most frequent infections in the neonatal period and in many cases lead to hospital admission of the newborn (NB). The aim of this study was to determine the incidence of EV in the etiology of neonatal meningitis and to define the clinical characteristics of newborns with EV meningitis. MATERIAL AND METHOD: Retrospective observational cohort study. Including 91 NBs with meningitis and gestational age greater than 34 weeks gestational age (GA) attended in our center over a period of 16 years. RESULTS: The percentage of NBs with EV meningitis was higher than that of NBs with bacterial meningitis (BM) and accounted for 78% (n=71). Half of the NBs with EV infection had a history of epidemic environment among their caregivers. Fever was present in 96% of cases as a clinical sign and, in general, sensory disturbances represented the main neurological alterations. Antibiotics (ATB) were given to 71.4% of patients with EV infection. Detection of EV in CSF samples showed a high sensitivity for the diagnosis of EV meningitis. The most frequently implicated EV types were echovirus 11, coxsackievirus B5, echovirus 18, 25 and 7. CONCLUSIONS: The results of this series show that enterovirus infection is a common cause of neonatal meningitis. These data underline the importance of rapid EV testing of infants with suspected meningitis. This allows early diagnosis and reduces antibiotic treatment, hospitalization time and related costs.

[Evaluation of the immunity level achieved with the oral polio vaccine in schoolchildren aged 6 to 12 years of Catalonia (Spain)]. / Evaluación del grado de protección inmunitaria conseguida con la vacuna oral antipoliomielítica en la población infantil de 6-12 años de Cataluña.

BACKGROUND AND OBJECTIVE: To evaluate the immunity level achieved with oral polio vaccine in schoolchildren aged 6-12 years of Catalonia (Spain). SUBJECTS AND METHOD: The prevalence of antibodies against poliovirus 1, 2 and 3 was investigated using the neutralizing technique in a representative (n = 197) sample of schoolchildren aged 6-12 years of Catalonia (Spain) obtained in 2001. RESULTS: The prevalence of antibodies was 94.4% for poliovirus 1; 98.5% for poliovirus 2, y 73.1% for poliovirus 3. 93.4% of serum samples had antibodies against poliovirus 1 and 2; 70.6% against poliovirus 1 and 3, and 69.5% against poliovirus 1, 2 and 3. The prevalence of antibodies was similar in different socio-demographic groups. Schoolchildren who had been vaccinated (5 doses) had a higher level of antibodies against poliovirus 3 than those who had not completed vaccination (4 or less doses): 75.4% vs 50.0% (p < 0.05). The prevalence of antibodies against poliovirus 1 and 2 was similar in schoolchildren completing and not completing vaccination. CONCLUSIONS: Results obtained in this study show that 26.9% of schoolchildren aged 6-12 years do not have an adequate immunity level against poliovirus 3 with the oral polio vaccine, being it necessary to develop an immunization program using the inactivated polio vaccine.

Evaluación del grado de protección inmunitaria conseguida con la vacuna oral antipoliomielítica en la población infantil de 6-12 años de Cataluña / Evaluation of the immunity level achieved with the oral polio vaccine in schoolchildren aged 6 to 12 years of Catalonia (Spain)

Fundamento y objetivo: Evaluar el grado de protección inmunitaria conseguida con la vacuna oral antipoliomielítica en la población escolar de 6-12 años de Cataluña. Sujetos y método: Se ha investigado la prevalencia de anticuerpos frente al virus de la polio 1, 2 y 3 mediante la técnica de seroneutralización en una muestra representativa (n = 197) de la población escolar de 6-12 años de Cataluña obtenida en el año 2001. Resultados: Se obtuvo una prevalencia de anticuerpos del 94,4% para el virus de la polio 1, del 98,5% para el virus de la polio 2 y del 73,1% para el virus de la polio 3. El 93,4% de las muestras estudiadas presentaba un grado protector de anticuerpos frente al virus de la polio 1 y 2; el 70,6% frente al virus de la polio 1 y 3, y el 69,5% frente al virus de la polio 1, 2 y 3. Ninguna variable sociodemográfica se asociaba con la prevalencia de anticuerpos. La prevalencia de anticuerpos frente al virus de la polio 3 fue significativamente mayor en los escolares que habían completado la vacunación (5 dosis) que en los que no la habían completado (4 dosis o menos): el 75,4 frente al 50,0% (p < 0,05). La prevalencia de anticuerpos frente al virus de la polio 1 y 2 fue similar en los escolares que habían completado la vacunación y en los que no la habían completado. Conclusiones: Los resultados de este estudio muestran que el 29,6% de la población escolar de 6-12 años no presenta anticuerpos frente al poliovirus 3 con la vacuna oral antipoliomielítica, por lo que es necesario desarrollar un programa de vacunación con la vacuna de la polio inactivada

Background and objetive: To evaluate the immunity level achieved with oral polio vaccine in schoolchildren aged 6-12 years of Catalonia (Spain). Subjects and method: The prevalence of antibodies against poliovirus 1, 2 and 3 was investigated using the neutralizing technique in a representative (n = 197) sample of schoolchildren aged 6-12 years of Catalonia (Spain) obtained in 2001. Results: The prevalence of antibodies was 94.4% for poliovirus 1; 98.5% for poliovirus 2, y 73.1% for poliovirus 3. 93.4% of serum samples had antibodies against poliovirus 1 and 2; 70.6% against poliovirus 1 and 3, and 69.5% against poliovirus 1, 2 and 3. The prevalence of antibodies was similar in different socio-demographic groups. Schoolchildren who had been vaccinated (5 doses) had a higher level of antibodies against poliovirus 3 than those who had not completed vaccination (4 or less doses): 75.4% vs 50.0% (p < 0.05). The prevalence of antibodies against poliovirus 1 and 2 was similar in schoolchildren completing and not completing vaccination. Conclusions: Results obtained in this study show that 26.9% of schoolchildren aged 6-12 years do not have an adequate immunity level against poliovirus 3 with the oral polio vaccine, being it necessary to develop an immunization program using the inactivated polio vaccine