Neonatal Colonization Research Articles

Incidence of <em>Candida</em> species colonization in neonatal intensive care unit at Riyadh Hospital, Saudi Arabia

Background: Candida species are important hospital-acquired pathogens in infants admitted to the neonatal intensive care unit (NICU). This study was performed in the NICU of Saudi Arabian Hospital, Riyadh region, KSA to analyze patterns of neonatal Candida colonization as well as to determine the potential risk factors.Methods: Weekly surveillance fungal cultures of anal area, oral cavity, umbilicus and ear canal of neonates were performed from birth until their discharge from the hospital. Colonization was analyzed for timing, site, species, birth weight and gestational age. Potential environmental reservoirs and hands of health care workers (HCWs) were also cultured monthly for fungi. Antifungal susceptibility of the identified isolates was also determined.Results: One hundred subjects have been recruited in this study. The overall colonization rate was 51%. Early colonization was found in 27 (27%) neonates whereas 24 (24%) neonates were lately colonized during their stay in NICU. Colonization was more in preterm neonates than in full and post term. Perianal area and oral cavity were the most frequent colonized sites. C. albicans was the main spp. (58.8%) isolated from the neonates followed by C. tropicalis (17.6%), C. glabrata (15.6%), and C. krusei (2%). Of the 51 isolated Candida spp., 68.6% were sensitive to fluconazole, 80% to itraconazole and 64.7% to ketoconazole, while only 33% were sensitive to amphotericin B.Conclusion: Candida has emerged as a common cause of infections in infants admitted to NICU, and C. albicans is the most commonly isolated candidal species. Neonatal infections caused by non- albicans species occur at a later age during their stay in NICU.

Factors associated with oral Candida colonization in neonates at intensive care unit

Background Oral candidiasis still has high prevalence andfrequently causes problems in the neonatal period.Objective To evaluate some factors associated with the occurrenceof oral Candida colonization in neonates.Methods A cross sectional study was performed at the IntensiveCare Unit, Neonatology Division, Department of Child Health,Medical School, Udayana University/Sanglah Hospital Denpasar,from November 2002 to April 2003. Eighty neonates were enrolled.Oral mucous swabs were obtained and examined for Candidacolonization using potassium hydroxide (KOH). Data were analyzedby prevalence ratio and logistic regression; a p value of <0.05 wasconsidered significant.Results The prevalence of oral Candida colonization was 55%(44/80). The colonization was significantly associated with age of>1 week, male sex, gestational age of <37 weeks, Apgar score of<7, birth weight of <1500 grams, oral mucous pH of <7, systemicantibiotic use, and steroid use by mother. Breastfeeding was aprotective factor. Correlation between variables using Spearmantest revealed correlation coefficient of <0.5. By logistic regres-sion, birth weight of <1500 grams (p=0.04) and systemic antibi-otic use (p=0.01) were significant associated factors of oralCandida colonization, while breastfeeding was a significant pro-tective factor (p=0.03).Conclusion Birth weight of <1500 grams and systemic antibioticuse were significant associated factors of oral Candida colonizationand breastfeeding was a significant protective factor of oral Candidacolonization in neonates

Cesarean Delivery and Neonatal Intestinal Colonization

Research Article| October 01 2016 Cesarean Delivery and Neonatal Intestinal Colonization AAP Grand Rounds (2016) 36 (4): 47. https://doi.org/10.1542/gr.36-4-47 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Cesarean Delivery and Neonatal Intestinal Colonization. AAP Grand Rounds October 2016; 36 (4): 47. https://doi.org/10.1542/gr.36-4-47 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: cesarean section, intestines, microbial colonization, newborn Source: Stokholm J, Thorsen J, Chawer BL, et al. Cesarean section changes neonatal gut colonization. J Allergy Clin Immunol. 2016; 138(3): 881– 889.e2; doi: https://doi.org/10.1016/j.jaci.2016.01.028Google Scholar Investigators from multiple institutions in Denmark conducted a prospective study to identify the relationship between route of delivery and subsequent bacterial colonization of the gastrointestinal tract and the airway in the first 12 months of life. Study participants included mothers and infants who had been enrolled in the Copenhagen Prospective Studies on Asthma, a cohort study of pregnant Danish women and their offspring. For the study, delivery route was categorized as vaginal, emergency cesarean (failed trial of labor), or elective cesarean (membranes ruptured at delivery). Fecal samples were collected and cultured on study children at 1 week, 1 month, and 1 year of life; hypopharyngeal samples were collected at 1 week, 1 month, and 3 months of life. Demographic information collected included maternal age, household income, maternal asthma, maternal smoking during pregnancy, pregnancy complications, the use of intrapartum antibiotics, older children in the home, and duration of breastfeeding. Rates of positive fecal and airway cultures for individual bacteria were compared among children born vaginally or by cesarean delivery. Of the 700 children in the cohort, 549 (78%) were born vaginally, 85 (12%) by emergency cesarean, and 66 (9%) by elective cesarean. All mothers who had cesarean delivery received intrapartum antibiotics compared to 13% of those who delivered vaginally. Fecal and airway samples were obtained on over 90% of enrolled newborns at most time points. The investigators found that at 1 week of life, intestinal colonization with Citrobacter freundii, Clostridium species, Enterobacter cloacae, Enterococcus faecalis, Klebsiella species, and Staphylococcus aureus were significantly associated with cesarean delivery (for either reason), and colonization with E. coli was significantly associated with vaginal delivery. These associations declined over time and disappeared by 1 year of life. No associations were found between route of delivery and airway colonization. The authors conclude that neonates delivered by cesarean section show a pattern of bacterial colonization in the first week of life that differs from that of babies delivered vaginally. They speculate that these differences may play a role in the development of immunemediated disease, such as asthma and allergy, later in life. Dr. Springer has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. There can be no doubt that while life-saving for some newborns with intrapartum obstetric complications, cesarean delivery is associated with higher incidence of postnatal complications for both mother1–3 and infant.2–5 In the United States, approximately 32% of all deliveries are via cesarean,2 although less than 15% are medically indicated.5 Recently, efforts have been undertaken to reduce the number of cesarean deliveries that are not medically indicated, both from a professional5 as well as economic perspective.6 The authors of the... You do not currently have access to this content.

Association of Chorioamnionitis with Aberrant Neonatal Gut Colonization and Adverse Clinical Outcomes.

ObjectiveChorioamnionitis (inflammation of the placenta and fetal membranes) and abnormal gastrointestinal colonization have been associated with an increased risk of sepsis and death in preterm infants, but whether chorioamnionitis causes abnormal pioneering gastrointestinal colonization in infants is not known. We determined the relationship between chorioamnionitis, altered infant fecal microbiome indicating abnormal gastrointestinal colonization, and adverse outcomes.Study DesignPreterm infants ≤ 28 weeks at birth were enrolled from 3 level III NICUs in Cincinnati, Ohio and Birmingham, Alabama. Sequencing for 16S microbial gene was performed on stool samples in the first 3 weeks of life. Chorioamnionitis was diagnosed by placental histology. Late onset sepsis and death outcomes were analyzed in relation to fecal microbiota and chorioamnionitis with or without funisitis (inflammation of the umbilical cord).ResultsOf the 106 enrolled infants, 48 infants had no chorioamnionitis, 32 infants had chorioamnionitis but no funisitis (AC), and 26 infants had chorioamnionitis with funisitis (ACF). The fecal samples from ACF infants collected by day of life 7 had higher relative abundance of family Mycoplasmataceae (phylum Tenericutes), genus Prevotella (phylum Bacteroidetes) and genus Sneathia (phylum Fusobacteria). Further, AC and ACF infants had higher incidence of late-onset sepsis/death as a combined outcome. Presence of specific clades in fecal samples, specifically, order Fusobacteria, genus Sneathia or family Mycoplasmataceae, were significantly associated with higher risk of sepsis or death.ConclusionThe results support the hypothesis that specific alterations in the pioneering infant gastrointestinal microbiota induced by chorioamnionitis predispose to neonatal sepsis or death.

Green synthesis of silver nanoparticles using Pimpinella anisum seeds: antimicrobial activity and cytotoxicity on human neonatal skin stromal cells and colon cancer cells.

BackgroundThe present study focused on a simple and eco-friendly method for the synthesis of silver nanoparticles (AgNPs) with multipurpose anticancer and antimicrobial activities.Materials and methodsWe studied a green synthesis route to produce AgNPs by using an aqueous extract of Pimpinella anisum seeds (3 mM). Their antimicrobial activity and cytotoxicity on human neonatal skin stromal cells (hSSCs) and colon cancer cells (HT115) were assessed.ResultsA biophysical characterization of the synthesized AgNPs was realized: the morphology of AgNPs was determined by transmission electron microscopy, energy dispersive spectroscopy, X-ray powder diffraction, and ultraviolet-vis absorption spectroscopy. Transmission electron microscopy showed spherical shapes of AgNPs of P. anisum seed extracts with a 3.2 nm minimum diameter and average diameter ranging from 3.2 to 16 nm. X-ray powder diffraction highlighted the crystalline nature of the nanoparticles, ultraviolet-vis absorption spectroscopy was used to monitor their synthesis, and Fourier transform infrared spectroscopy showed the main reducing groups from the seed extract. Energy dispersive spectroscopy was used to confirm the presence of elemental silver. We evaluated the antimicrobial potential of green-synthesized AgNPs against five infectious bacteria: Staphylococcus pyogenes (29213), Acinetobacter baumannii (4436), Klebsiella pneumoniae (G455), Salmonella typhi, and Pseudomonas aeruginosa. In addition, we focused on the toxicological effects of AgNPs against hSSC cells and HT115 cells by using in vitro proliferation tests and cell viability assays. Among the different tested concentrations of nanoparticles, doses < 10 µg showed few adverse effects on cell proliferation without variations in viability, whereas doses >10 µg led to increased cytotoxicity.ConclusionOverall, our results highlighted the capacity of P. anisum-synthesized AgNPs as novel and cheap bioreducing agents for eco-friendly nanosynthetical routes. The data confirm the multipurpose potential of plant-borne reducing and stabilizing agents in nanotechnology.

Early Gut Colonization of Preterm Infants: Effect of Enteral Feeding Tubes.

The aim of the study was to evaluate the potential colonization of nosocomial bacteria in enteral feeding systems and its effect on early gut colonization of preterm neonates. Mother's own milk, donor milk, and preterm formula samples obtained after passing through the external part of the enteral feeding tubes were cultured. In addition, meconium and fecal samples from 26 preterm infants collected at different time points until discharge were cultured. Random amplification polymorphism DNA and pulse field gel electrophoresis were performed to confirm the presence of specific bacterial strains in milk and infant fecal samples. Approximately 4000 bacterial isolates were identified at the species level. The dominant species in both feces from preterm infants and milk samples were Staphylococcus epidermidis, S aureus, Enterococcus faecalis, E faecium, Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli. All of them were present at high concentrations independently of the feeding mode. Random amplification polymorphism DNA and pulse field gel electrophoresis techniques showed that several bacteria strains were found in both type of samples. Furthermore, scanning electron microscopy revealed the presence of a dense bacterial biofilm in several parts of the feeding tubes and the tube connectors. There is a sharing of bacterial strains between the neonates' gastrointestinal microbiota and the feeding tubes used to feed them.

Enhanced sympathetic nerve activity induced by neonatal colon inflammation induces gastric hypersensitivity and anxiety-like behavior in adult rats.

Gastric hypersensitivity (GHS) and anxiety are prevalent in functional dyspepsia patients; their underlying mechanisms remain unknown largely because of lack of availability of live visceral tissues from human subjects. Recently, we demonstrated in a preclinical model that rats subjected to neonatal colon inflammation show increased basal plasma norepinephrine (NE), which contributes to GHS through the upregulation of nerve growth factor (NGF) expression in the gastric fundus. We tested the hypothesis that neonatal colon inflammation increases anxiety-like behavior and sympathetic nervous system activity, which upregulates the expression of NGF to induce GHS in adult life. Chemical sympathectomy, but not adrenalectomy, suppressed the elevated NGF expression in the fundus muscularis externa and GHS. The measurement of heart rate variability showed a significant increase in the low frequency-to-high frequency ratio in GHS vs. the control rats. Stimulus-evoked release of NE from the fundus muscularis externa strips was significantly greater in GHS than in the control rats. Tyrosine hydroxylase expression was increased in the celiac ganglia of the GHS vs. the control rats. We found an increase in trait but not stress-induced anxiety-like behavior in GHS rats in an elevated plus maze. We concluded that neonatal programming triggered by colon inflammation upregulates tyrosine hydroxylase in the celiac ganglia, which upregulates the release of NE in the gastric fundus muscularis externa. The increase of NE release from the sympathetic nerve terminals concentration dependently upregulates NGF, which proportionately increases the visceromotor response to gastric distention. Neonatal programming concurrently increases anxiety-like behavior in GHS rats.

Oropharyngeal Perinatal Colonization by Human Papillomavirus

Introduction and objectiveHuman papillomavirus (HPV) infection is the most common human sexually transmitted disease. It is clinically relevant because this condition is necessary for the development of epithelial cervical cancer, and it is also a factor closely associated with the occurrence of diverse tumours and various benign and malignant lesions of the head and neck area. The infective mechanism in most of these cases is associated with sexual intercourse, but there is recent scientific evidence suggesting that HPV infection may also be acquired by other routes of infection not necessarily linked to sexual contact. One of them is vertical transmission from mother to child, either during pregnancy or at the time of delivery.The aim of our research was to study maternal–foetal HPV transmission during childbirth in detail, establishing the rate of oropharyngeal neonatal HPV in vaginal deliveries. MethodThe presence and type of HPV viral DNA at the time of delivery in samples of maternal cervical secretions, amniotic fluid, venous cord blood samples and neonatal oropharynx in pregnant women (and their babies) were determined. ResultsThe rate of oropharyngeal neonatal HPV colonization in vaginal deliveries was 58.24%. ConclusionsThe maternal and neonatal HPV colonization mechanism is essentially, but not exclusively, transvaginal.

Susceptibility to Lower Respiratory Infections in Childhood is Associated with Perturbation of the Cytokine Response to Pathogenic Airway Bacteria.

Neonatal colonization of the airways with respiratory pathogens is associated with increased risk of lower respiratory infections (LRI) in early childhood. Therefore, we hypothesized that children developing LRI have an aberrant immune response to pathogenic bacteria in infancy. The objective was to characterize in vitro the early life systemic immune response to pathogenic bacteria and study the possible association with incidence of LRI during the first 3 years of life. The Copenhagen Prospective Studies on Asthma in Childhood2000 (COPSAC2000) is a clinical birth cohort study of 411 children born of mothers with asthma. LRI incidence was prospectively captured from 6-monthly planned visits and visits at acute respiratory episodes. The in vitro systemic immune response to Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae was characterized by the production of TNF-α, IFN-γ, IL-2, IL-5, IL-10, IL-13 and IL-17 in peripheral blood mononuclear cells isolated at age 6 months from 291 infants. Data were analyzed by Poisson regression against incidence of LRI in infancy. A multivariable model including all cytokine responses from the 3 different bacterial stimulations significantly identified children at risk of LRI (P = 0.006). The immune response pattern associated with LRI was characterized by perturbed production of several cytokines rather than production of one specific cytokine, and was independent of concurrent asthma. TNF-α and IL-5 were key drivers but did not explain the entire variation in LRI susceptibility. Children at risk of future LRI present a perturbed systemic immune response upon exposure to common airway pathogens in early life.

Neonatal colonization of mice with LGG promotes intestinal development and decreases susceptibility to colitis in adulthood.

Development of the intestinal microbiota during early life serves a key regulatory stage in establishing the host-microbial relationship. This symbiotic relationship contributes to developing host immunity and maintaining health throughout the life span. This study was to develop an approach to colonize conventionally raised mice with a model probiotic bacterium, Lactobacillus rhamnosus GG (LGG), and determine the effects of LGG colonization on intestinal development and prevention of colitis in adulthood. LGG colonization in conventionally raised was established by administering LGG to pregnant mice starting at gestational day 18 and pups at postnatal day 1 to day 5. LGG colonization promoted bodyweight gain and increased diversity and richness of the colonic mucosa-associated microbiota prior to weaning. Intestinal epithelial cell proliferation, differentiation, tight junction formation and mucosal IgA production were all significantly enhanced in LGG colonized mice. Adult mice colonized with LGG showed increased IgA production and decreased susceptibility to intestinal injury and inflammation induced in the dextran sodium sulphate model of colitis. Thus, neonatal colonization of mice with LGG enhances intestinal functional maturation and IgA production and confers life long health consequences on protection from intestinal injury and inflammation. This strategy might be applied for benefiting health in the host.

Su1872 Age-Related Influence of Colonization by an AIEC Pathobiont on the Severity of DSS-Induced Colitis

Background:The gastrointestinal microbiota is initially acquired during birth and evolves throughout the postnatal period reaching a mature microbial community (i.e., composition and abundance) over time. In this regard, few studies have evaluated the impact of neonatal colonization by a pathobiont

In vitro assessment of bacterial colonisation rates of goat umbilical cord segments using three embodiments of a novel neonatal umbilical catheter protection device

IntroductionCentral line-associated bloodstream infections (CLABSIs) in neonates with umbilical catheters occur at a rate that is 5 times higher than CLABSIs in adults with central catheters. No device currently exists...

Neonatal pneumococcal colonisation caused by Influenza A infection alters lung function in adult mice.

There is emerging epidemiological data to suggest that upper respiratory tract bacterial colonisation in infancy may increase the risk of developing respiratory dysfunction later in life, and respiratory viruses are known to precipitate persistent colonisation. This study utilized a neonatal mouse model of Streptococcus pneumonia (SP) and influenza A virus (IAV) co-infection, where bronchoalveolar leukocyte infiltration had resolved by adulthood. Only co-infection resulted in persistent nasopharyngeal colonisation over 40 days and a significant increase in airway resistance in response to in vivo methacholine challenge. A significant increase in hysteresivity was also observed in IAV and co-infected mice, consistent with ventilatory heterogeneity and structural changes in the adult lung. Airway hyper-responsiveness was not associated with a detectable increase in goblet cell transdifferentiation, peribronchial smooth muscle bulk or collagen deposition in regions surrounding the airways. Increased reactivity was not observed in precision cut lung slices challenged with methacholine in vitro. Histologically, the airway epithelium appeared normal and expression of epithelial integrity markers (ZO-1, occludin-1 and E-cadherin) were not altered. In summary, neonatal co-infection led to persistent nasopharyngeal colonisation and increased airway responsiveness that was not associated with detectable smooth muscle or mucosal epithelial abnormalities, however increased hysteresivity may reflect ventilation heterogeneity.

Human gut colonisation may be initiated in utero by distinct microbial communities in the placenta and amniotic fluid.

Interaction with intestinal microbes in infancy has a profound impact on health and disease in later life through programming of immune and metabolic pathways. We collected maternal faeces, placenta, amniotic fluid, colostrum, meconium and infant faeces samples from 15 mother-infant pairs in an effort to rigorously investigate prenatal and neonatal microbial transfer and gut colonisation. To ensure sterile sampling, only deliveries at full term by elective caesarean section were studied. Microbiota composition and activity assessment by conventional bacterial culture, 16S rRNA gene pyrosequencing, quantitative PCR, and denaturing gradient gel electrophoresis revealed that the placenta and amniotic fluid harbour a distinct microbiota characterised by low richness, low diversity and the predominance of Proteobacteria. Shared features between the microbiota detected in the placenta and amniotic fluid and in infant meconium suggest microbial transfer at the foeto-maternal interface. At the age of 3–4 days, the infant gut microbiota composition begins to resemble that detected in colostrum. Based on these data, we propose that the stepwise microbial gut colonisation process may be initiated already prenatally by a distinct microbiota in the placenta and amniotic fluid. The link between the mother and the offspring is continued after birth by microbes present in breast milk.

Organotypical Tissue Cultures from Fetal and Neonatal Murine Colon.

The complex functions of the gastrointestinal tract rely on the coordinated interplay of several cell and tissue types involving epithelium, connective tissue, smooth muscles as well as cells of the immune and nervous system. It is therefore obvious, that these functions can hardly be investigated sufficiently using cell lines or two-dimensional cell cultures.Here, we describe an easy to produce three-dimensional organotypical explants culture from fetal and neonatal murine colon. This model is suitable for in vitro testing of intestinal function or the evaluation of developmental or pathological processes.

Vaginal Microbiota and Lubricant Use During Labor

The human microbiome profoundly influences health promotion and disease prevention. Improved DNA and RNA sequencing technologies have enhanced our knowledge on the composition of the various microbial communities that constitute the microbiome. The structure and stability of the vaginal microbiota is of particular importance during pregnancy and labor because maternal microbes form the basis of the neonate’s own microbiome during the birth process. Vaginal dysbiosis, or perterbations in vaginal microbial composition, that occurs during labor can lead to suboptimal neonatal colonization and may be linked to adverse health outcomes for infants and children, including asthma and obesity. Vaginal dysbiosis is linked with many factors, including the use of personal lubricants. Studies using cell and animal models show that lubricants can alter microbial composition as well as damage the integrity of vaginal epithelial cells. These findings are concerning because similar lubricants are frequently used during labor. However, the effect of lubricant use on vaginal microbiota in the health-care setting has not been studied. This article presents current evidence on vaginal microbiota during pregnancy with a focus on the influence of a common practice, lubricant use during labor. Areas for future research are presented, as well as practice and policy implications for perinatal health-care providers.

Noninflammatory upregulation of nerve growth factor underlies gastric hypersensitivity induced by neonatal colon inflammation.

Gastric hypersensitivity is one of the key contributors to the postprandial symptoms of epigastric pain/discomfort, satiety, and fullness in functional dyspepsia patients. Epidemiological studies found that adverse early-life experiences are risk factors for the development of gastric hypersensitivity. Preclinical studies found that neonatal colon inflammation elevates plasma norepinephrine (NE), which upregulates expression of nerve growth factor (NGF) in the muscularis externa of the gastric fundus. Our goal was to investigate the cellular mechanisms by which NE upregulates the expression of NGF in gastric hypersensitive (GHS) rats, which were subjected previously to neonatal colon inflammation. Neonatal colon inflammation upregulated NGF protein, but not mRNA, in the gastric fundus of GHS rats. Western blotting showed upregulation of p110γ of phosphatidylinositol 4,5-bisphosphate 3-kinase (PI3K), phosphoinositide-dependent kinase-1 (PDK1), pAKT(Ser473), and phosphorylated 4E-binding protein (p4E-BP1)(Thr70), suggesting AKT activation and enhanced NGF protein translation. AKT inhibitor MK-2206 blocked the upregulation of NGF in the fundus of GHS rats. Matrix metalloproteinase 9 (MMP-9), the major NGF-degrading protease, was suppressed, indicating that NGF degradation was impeded. Incubation of fundus muscularis externa with NE upregulated NGF by modulating the protein translation and degradation pathways. Yohimbine, an α2-adrenergic receptor antagonist, upregulated plasma NE and NGF expression by activating the protein translation and degradation pathways in naive rats. In contrast, a cocktail of adrenergic receptor antagonists suppressed the upregulation of NGF by blocking the activation of the protein translation and degradation pathways. Our findings provide evidence that the elevation of plasma NE induces NGF expression in the gastric fundus.

Neonatal Ureaplasma urealyticum colonization increases pulmonary and cerebral morbidity despite treatment with macrolide antibiotics.

To evaluate the influence of Ureaplasma urealyticum (UU) colonization on neonatal pulmonary and cerebral morbidity. Single-center case-control study including all preterm infants with positive UU tracheal colonization between 1990 and 2012. Cases were matched with controls by birth year, gestational age, birth weight, and sex. All cases had received macrolide antibiotics for UU infection starting at the time of first positive culture results from tracheal aspirates. Main outcome parameters included presence and severity of hyaline membrane disease (IRDS), duration of ventilation, bronchopulmonary dysplasia at 36 postmenstrual age and neurological morbidities (seizures, intra-/periventricular hemorrhages-I/PVH, periventricular leukomalacia-PVL). Of 74 cases identified 8 died and 4 had to be excluded; thus, 62 preterm infants were compared to 62 matched controls. UU was significantly associated with IRDS (79 vs. 61%, p=0.015), BPD (24 vs. 6%, p=0.003), seizures (23 vs. 5%, p=0.002) and I/PVH (45 vs. 24%, p=0.028). Cases had longer duration of mechanical ventilation and total duration of invasive and non-invasive ventilation (median 11 vs. 6days p=0.006 and 25 vs. 16.5days p=0.019, respectively). UU was found to be significantly associated with pulmonary short- and long-term morbidity and mild cerebral impairment despite treatment with macrolide antibiotics.

Probiotic supplementation for preventing invasive fungal infections in preterm neonates--a systematic review and meta-analysis.

Invasive fungal infections (IFI) are associated with significant health burden in preterm neonates. The objective of this study was to systematically review effect of probiotic supplementation (PS) for preventing IFI in preterm neonates. We searched Cochrane Central Register of Controlled Trials, Medline, Embase, Cumulative Index of Nursing and Allied Health Literature, and proceedings of the Pediatric Academic Society meetings in August 2014. Study selection was performed on randomised controlled trials (RCT) of PS in neonates born <37 weeks. Primary outcome of this study was IFI (Isolation of fungus in blood/body fluids) and secondary outcome was fungal gut colonisation. Information on IFI/colonisation was available in 8 of 27 RCT. Meta-analysis (fixed effects model) showed that PS reduced the risk of IFI (RR: 0.50, 95% CI: 0.34, 0.73, I(2) = 39%). Results were not significant with random effects model (RR: 0.64, 95%, CI: 0.30, 1.38, P = 0.25, I(2) = 39%). Analysis after excluding the study with a high baseline incidence (75%) of IFI showed that PS had no significant benefits (RR: 0.89; 95% CI: 0.44, 1.78). Of the five studies reporting on fungal gut colonisation, three reported benefits of probiotics; two did not. Current evidence is limited to derive firm conclusions on the effect of PS for preventing IFI/gut colonisation in preterm neonates.

Colonización orofaríngea perinatal por el virus del papiloma humano

Introduction and objectiveHuman papillomavirus (HPV) infection is the most common human sexually transmitted disease. It is clinically relevant because this condition is necessary for the development of epithelial cervical cancer, and it is also a factor closely associated with the occurrence of diverse tumours and various benign and malignant lesions of the head and neck area. The infective mechanism in most of these cases is associated with sexual intercourse, but there is recent scientific evidence suggesting that HPV infection may also be acquired by other routes of infection not necessarily linked to sexual contact. One of them is vertical transmission from mother to child, either during pregnancy or at the time of delivery.The aim of our research was to study maternal-foetal HPV transmission during childbirth in detail, establishing the rate of oropharyngeal neonatal HPV in vaginal deliveries. MethodThe presence and type of HPV viral DNA at the time of delivery in samples of maternal cervical secretions, amniotic fluid, venous cord blood samples and neonatal oropharynx in pregnant women (and their babies) were determined. ResultsThe rate of oropharyngeal neonatal HPV colonization in vaginal deliveries was 58.24%. ConclusionsThe maternal and neonatal HPV colonization mechanism is essentially, but not exclusively, transvaginal.