Neonatal Infection Research Articles

Maternal-Newborn ABO Blood Group Congruence Among Consecutive Births and Risk of Serious Neonatal Infection: Retrospective Cohort Study.

Differing ABO blood groups between a mother and her fetus may confer a lower risk of serious neonatal infection. How sensitization in the first pregnancy influences this phenomenon in a subsequent pregnancy is unclear. Accordingly, this study determined whether maternal-newborn ABO blood group incongruence in a first pregnancy further modifies the risk of serious infection in a subsequent pregnancy marked by ABO incongruency. This population-based retrospective cohort study used linked patient-level datasets in Ontario, Canada, from 2008 to 2022. Included were mothers with 2 consecutive live births, with recorded maternal and newborn ABO blood group data. The exposure considered both first- and second-born siblings' ABO blood group congruency with their mother. The outcome was a serious neonatal infection within 27 days after birth. Logistic regression models generated adjusted odds ratios (aORs) and 95% confidence intervals (CIs), adjusted for gestational age at birth. Included were 14,739 mother-infant triads. Relative to maternal-newborn congruency in the second pregnancy, incongruent ABO blood groups in the second pregnancy were associated with an aOR of 0.72 (95% CI, 0.53-0.97) for a serious neonatal infection arising in the second-born infant. However, if the first and second siblings each had incongruent ABO blood groups with their mother, the aOR of serious infection in the second-born infant was not significantly lower [0.74 (95% CI, 0.52-1.06)]. Second-born infants whose ABO blood group was incongruent with that of their mother had a lower risk of serious neonatal infection. However, ABO incongruence from a prior birth did not modify that relation.

Suggested Dosing of Select Beta-lactam Agents for the Treatment of Antimicrobial-Resistant Gram-Negative Infections in Children.

The Infectious Diseases Society of America (IDSA) publishes annual guidance on the treatment of antimicrobial-resistant (AMR) gram-negative infections. Within the AMR guidance, suggested dosages of antibiotics for adults infected with AMR pathogens are provided. This document serves as a companion document to the IDSA guidance to assist pediatric specialists with dosing β-lactam agents for the treatment of AMR infections in children. A panel of 13 pediatric infectious diseases specialists, including 11 pharmacists and two physicians, reviewed existing pharmacokinetic/pharmacodynamic, animal, and clinical data for newer β-lactam agents that are available in the United States and suggested for the treatment of AMR infections (i.e., cefiderocol, ceftazidime-avibactam, ceftazidime-avibactam & aztreonam, ceftolozane-tazobactam, imipenem-cilastatin-relebactam, meropenem-vaborbactam, sulbactam-durlobactam). Suggested dosing for ampicillin-sulbactam is also provided given complexities in appropriate dosing for carbapenem-resistant Acinetobacter baumannii infections. Consensus-based suggested dosing for β-lactam agents used to treat AMR infections in neonates, infants, children, and adolescents and relevant supporting evidence are provided. Content is up to date as of December 1st, 2024. Gaps and limitations to existing data are discussed. Optimizing antibiotic dosing is critical to improving the outcomes of children with AMR infections.

Evaluation and Management of Congenital Cytomegalovirus Infection.

The purpose of this review is to serve as an update on congenital cytomegalovirus (CMV) evaluation and management for obstetrician-gynecologists and to provide a framework for counseling birthing people at risk for or diagnosed with a primary CMV infection or reactivation or reinfection during pregnancy. A DNA virus, CMV is the most common congenital viral infection and the most common cause of nongenetic childhood hearing loss in the United States. The risk of congenital CMV infection from transplacental viral transfer depends on the gestational age at the time of maternal infection and whether the infection is primary or nonprimary. Although the risk of congenital CMV infection is lower with infection at earlier gestational ages, clinical sequelae are more severe with maternal infections earlier in gestation. At present, routine screening for maternal CMV infection is not recommended by U.S. guidelines. When maternal primary infection is confirmed in early pregnancy, emerging data support consideration of maternal antiviral therapy to prevent congenital CMV infection. When congenital CMV infection is confirmed, typically after an abnormal prenatal ultrasound result, there are more limited data on the utility of maternal antiviral therapy. Universal newborn screening for congenital CMV infection is not mandatory in most U.S. states at present. Newborns diagnosed with congenital CMV infection undergo an extensive evaluation to determine whether neurologic symptoms are present, which guides postnatal evaluation and management. In this review, we discuss the diagnosis and management of maternal CMV infection, the risk and diagnosis of congenital CMV infection, prevention and potential treatment of congenital CMV infection in utero, and neonatal congenital CMV infection diagnosis and management.

Immunogenicity of an in-silico designed multi-epitope DNA vaccine encoding ROP21 and ROP29 of Toxoplasma gondii against both acute and chronic toxoplasmosis in BALB/c mice.

Toxoplasma infections are highly prevalent worldwide and can cause serious complications in immunocompromised individuals and lead to congenital infections in neonates. Despite ongoing efforts to develop T. gondii vaccines, none have been developed. A potential target, the ROP21 protein catalyzes the phosphorylation of additional protein substrates and ROP29 is critical for chronic Toxoplasma gondii infection. In this study, recombinant plasmid with epitopes of ROP21 and ROP29 were used as DNA vaccine. An immunoinformatics approach was employed to design a multi-epitope DNA vaccine encoding T. gondii ROP21 and ROP29. The bioinformatic outputs supported the immunogenic and non-allergic nature of multi-epitope vaccine. The recombinant plasmid was transfected in HEK cells. Thereafter, the protective effect of the DNA vaccine was evaluated in BALB/c mice by way of vaccination and challenge of these mice with acute RH and chronic PRU strains of T. gondii, respectively. The immunological responses of the control and vaccinated groups were assessed using survival time, lymphocyte proliferation assays, cytokine and antibody measurements, and determination of the parasite load in the spleen with real-time PCR. Multiple epitope (ROP21 and ROP29) DNA immunization stimulated cellular and humoral immune reactions in BALB/c mice and lengthened their life following challenge. Multiple epitope proteins increased significantly the total IgG antibody concentrations, triggered increased IFN-γ cytokine production, increased the mixed IgG1/IgG2a response with a predominance of IgG2a, prolonged the survival duration and reduced the number of brain cysts. The in vivo findings indicated that the multi-epitope DNA vaccine elicited significant production of IgG antibodies (122.16ng/ml) as well as IFN-γ (12.37pg/ml) (p<0.05). Moreover, a significantly reduced parasite-burden (CT: 35.62) and prolonged survival time (14 days) were observed in the immunized groups compared to the controls (p<0.05). Low IL-4 (5.63pg/ml) values were detected in vaccinated mice compared to the PBS control (p>0.05). We found that multiepitope protein vaccination could provide more protective immunity against chronic and acute toxoplasmosis infection compared to control.

A Case of Fulminant Hepatic Failure with Neonatal Cholestasis Caused by Disseminated Herpes Simplex Virus (HSV) Infection

Background: Disseminated herpes simplex virus infection is an life threatening infection which may initially present as cholestasis, but eventually lead to multiple organ failure with a high mortality rate. But the good news is that the introduction of antiviral agent like acyclovir for the treatment of neonatal herpes has significantly improved the outcome of this potentially devastating infection. The early initiation of acyclovir highly depends on clinician’s suspicion, especially when overt signs of the infection are absent. So the objective of our case report was to raise awareness among the physicians to consider herpes virus infection in the differential when a patient present with features of cholestasis and hepatic failure. Case Presentation: Our case is aone month old male infant who got admitted in Chittagong Medical Hospital on 7th January, 2023 with the complaints of lethargy, blood mixed vomiting and black stool for 1 day with a history of jaundice and pale stool from 3rd week of life. His bleeding manifestations exacerbated and developed features of hepatic failure with coagulopathy. He was treated with plasma transfusion, viamin k, injectable antibiotics and other supportive care. A TORCH panel was sent. HSV Ig G came positive with 12 folds increased titre. Observing his deteriorating consciousness level intravenous acyclovir 60 mg/kg/day was initiated on 16th January, 2023. Within 3-4 days his overall general condition improved. The baby was discharged after getting 21 days of acyclovir therapy. Conclusion: Neonatal herpes virus infection can be a life threatening condition. An early diagnosis and effective treatment with antiviral agent can reduce morbidity and mortality. Chatt Maa Shi Hosp Med Coll J; Vol.23 (1); January 2024; Page 99-103

No Difference in Outcomes with Early vs. Late Antibiotic Prophylaxis for Term PROM: A Multi-Center Analysis.

While guidelines suggest administering antibiotics 12 to 18 hours after the rupture of membranes in term premature rupture of membranes (PROM) women, in practice, clinicians tend to initiate prophylactic antibiotics as soon as possible to avoid risk of infection. This study aimed to assess whether early administration of prophylactic antibiotics for term premature rupture of membranes reduces the incidence of maternal and neonatal infections. This multi-center, prospective cohort study included women with term premature rupture of membranes. Participants were divided into early and late administration groups according to the duration between membranes rupture and antibiotic use. The effectiveness outcomes included the incidence of puerperal infection, the incidence of total maternal infection, the rate of neonatal sepsis, among others; the safety outcomes included the incidence of adverse reactions; and Antibiotics Use Density was used to assess the antibiotic consumption. Propensity score matching method was used to control confounding. A total of 1099 women with term PROM were enrolled, 459 in the early group-6 hours (antibiotics administration within 6 hours) and 640 in the late group-6 hours (antibiotics administration after 6 hours); 707 in the early group-12 hours (antibiotics administration within 12 hours) and 392 in the late group-12 hours (antibiotics administration after 12 hours). After propensity score matching, there were 300 women in each of the 6-hour groups and 230 women in each of the 12-hour groups. Baseline characteristics showed no significant differences between matched groups (P>0.05). The early 6-hour and 12-hour groups had lower maternal C-reactive protein levels compared to the late groups (P<0.05), but no significant differences in other maternal and neonatal outcomes. Adverse reactions showed no statistical significance between early and late groups (P=1.000). Antibiotic use density was higher in the early treatment groups by 10.1 defined daily doses (DDDs) (6-hour) and 11.7 DDDs (12-hour). There was no statistical difference in the efficacy and safety when antibiotics administered within 6-12 hours after rupture of membranes, compared to after 6-12 hours in women with term PROM. Meanwhile delayed use significantly reduces the antibiotic consumption.

Theoretical impact of a bedside decision-making tool on antibiotic use for suspected neonatal healthcare-associated infection: an observational study

Background and objectivesHealthcare-associated infections (HAI) are a leading contributor to morbidity and mortality in hospitalised neonates. Diagnosing neonatal HAI is challenging owing to non-specific symptoms and lack of definitive diagnostic markers, contributing to high rates of inappropriate antibiotic use. This study evaluated the theoretical impact of implementing a bedside tool for decision-making on antibiotic length of therapy (LOT).MethodsThis prospective observational physician-blinded study consecutively enrolled patients with suspected HAI events at a large South African neonatal unit from September 2022 to September 2023. The antibiotic decision-making tool included an infection prediction score (NeoHoP), and a point-of-care C-reactive protein test (CRP) performed at HAI diagnosis and 24 h later. The theoretical impact of the tool on antibiotic LOT was calculated.ResultsWe recruited 180 neonates with 214 episodes of suspected HAI, of which 22 (10.3%) were proven HAI, 56 (26.2%) were presumed HAI and 136 (63.6%) had HAI ruled out. The median observed antibiotic LOT was three days (9 days for proven HAI, 7 days for presumed HAI, and 3 days for no HAI). The antibiotic decision-making tool would theoretically reduce overall antibiotic LOT by 2 days (p < 0.001), particularly in neonates where HAI was subsequently excluded.ConclusionWe developed an antibiotic decision-making tool to support the clinical evaluation of suspected neonatal HAI and demonstrated a significant potential impact on reducing antibiotic LOT. Given increasing antibiotic resistance rates globally, this tool should be further evaluated to minimise unnecessary antibiotic use in hospitalised neonates.

Streptococcus canis Rapidly Progressive and Fatal Neonatal Sepsis in a Term Infant.

Streptococcus canis (S. canis), belonging to β-hemolytic group G streptococci, is increasingly reported to cause sepsis and severe infections in adults with comorbidities but is rarely reported in children. We describe a case of S. canis neonatal sepsis in a term infant with a rapidly fatal outcome. We reviewed the literature on neonatal infections due to all group G streptococci including S. canis. We identified 10 articles describing 19 cases of neonatal sepsis due to group G streptococcus, of which only 3 cases were identified at the species level. Most patients presented in the first week of life with neonatal sepsis with bacteremia present in 90% of cases. Among the patients, gestational age ranged from 31 to 42 weeks. Prematurity was reported in 35% of the patients. All patients were treated with β-lactams with or without aminoglycosides. Mortality was 26%. S. canis infection is rare in the setting of neonatal sepsis; however, it can lead to high morbidity and mortality. It is imperative to promptly administer empiric antibiotics for critically ill neonates until neonatal sepsis is ruled out. β-lactams provide adequate coverage against S. canis. Further epidemiological and clinical studies focusing on S. canis are needed to fully understand the transmission and disease burden of this pathogen in neonates.

Near-term and Intrapartum Care of Mothers for Perinatal and Newborn Outcomes.

Near-term and intrapartum care play pivotal roles in ensuring a safe childbirth experience and are essential components of a comprehensive approach to maternal and neonatal health. The following interventions were identified: antibiotics for preterm premature rupture of membrane, antenatal corticosteroids for fetal lung maturation, partograph use during labor and delivery, induction of labor at or post term, skilled birth care and safe childbirth checklist during labor and delivery. A scoping exercise was conducted to ascertain the most up-to-date evidence, and reviews of topics of interest were updated in case the evidence was not recent, with a focus on low- and middle- income countries (LMICs). Antibiotics reduced the overall risk of neonatal infection including pneumonia [RR 0.67 (0.52 to 0.85)]. LMIC evidence showed a significant effect of antenatal steroids on the risk of neonatal mortality [RR 0.64 (0.43 to 0.97)] and respiratory distress syndrome [RR 0.65 (0.44 to 0.96)]. Induction of labor practices at term or post-term reduced the risk of meconium aspiration syndrome [RR 0.51 (0.34 to 0.76)]. The use of the WHO childbirth checklist significantly raised the standard of pre-eclampsia care [OR 8.09 (2.55 to 25.63)] as well as of maternal infection management [OR 25.44 (4.09 to 158.08)]. LMIC-specific evidence also demonstrated a significant reduction in the risk of stillbirth [OR 0.92 (0.87 to 0.96)]. Further research initiatives pertaining to health interventions delivered to expectant mothers near term or during the intrapartum period can contribute to a more inclusive understanding of health challenges in LMICs.

Maternal and neonatal outcomes of Group B Streptococcus colonization: a retrospective study

BackgroundGroup B Streptococcus (GBS) colonization is one of the major causes of severe neonatal infections. The study was intended to identify GBS colonization in pregnant women, explore its potential risk factors, and analyze the impact of GBS on outcomes for both mothers and newborns.Material and MethodsA retrospective research was carried out on pregnant women who had undergone GBS screening and delivered from June 2020 to December 2022. Pregnant women between 35 and 37 weeks of gestation had GBS screening using real-time polymerase chain reaction (RT-PCR). The clinical characteristics and outcomes of mothers and newborns were collected. The risk factors linked to maternal GBS colonization and its impact on adverse outcomes for mothers and neonates were assessed using chi-square and logistic regression analyses. The composite neonatal adverse outcomes included low Apgar scores, neonatal pneumonia, neonatal hyperbilirubinemia, neonatal sepsis, or low birth weight.ResultsOverall, the rate of GBS positivity was 10.63% (551/5183), and the rate of maternal GBS screening was 88.4%. Diabetic pregnant women were more likely to become colonized with GBS. Our research revealed that GBS carriers experienced higher rates of fetal distress and neonatal adverse outcomes than non-GBS carriers. Fetal distress (OR, 1.940; 95% CI, 1.355 to 2.778, P < 0.001), neonatal sepsis (OR, 5.063; 95% CI, 2.536–10.109, P < 0.001), low Apgar scores (OR, 2.097; 95% CI, 1.184–3.715, P = 0.011), neonatal pneumonia (OR, 1.638; 95% CI, 1.039 to 2.582, P = 0.034) and neonatal hyperbilirubinemia (OR, 1.438; 95% CI, 1.080 to 1.915, P = 0.013) were significantly related to maternal GBS colonization. When we used the composite adverse neonatal outcomes as the dependent variable and analyzed the influencing factors, the logistic regression analysis revealed that GBS colonization was still significantly related to an elevated risk of adverse neonatal outcomes (OR = 1.752, 95% CI, 1.389–2.208; P < 0.001).ConclusionsDiabetes may be a risk factor for maternal GBS colonization. Moreover, in this study, GBS colonization correlated with neonatal adverse outcomes but not with maternal outcomes.

Impact and Contributing Factors of Maternal Pyrexia Peaks During Labor on Maternal and Neonatal Outcomes.

This study aims to equip clinicians with the necessary insights for identifying and managing pregnant women experiencing elevated maternal pyrexia during labor. It examines maternal and neonatal outcomes along with the factors associated with varying peak temperatures. A retrospective analysis was conducted on 319 pregnant women presenting with maternal pyrexia during labor. Participants were categorized into two groups based on peak temperature: Group A (n = 180, temperature <38°C) and Group B (n = 139, temperature ≥38°C). Basic characteristics, blood markers, and maternal and neonatal outcomes were compared between the two groups. (1) Group B exhibited a higher percentage of neutrophilic granulocytes (NE%) and C-reactive protein to lymphocyte ratio (CLR) compared with Group A (p < 0.05). (2) The rates of meconium-stained amniotic fluid, histological chorioamnionitis, hospitalization of neonates, and infections in neonates were greater in Group B than in Group A (p < 0.05). (3) Logistic regression analysis identified elevated CLR levels as a risk factor for peak temperatures exceeding 38°C, indicating that CLR could serve as a reliable predictor of maternal pyrexia above 38°C during labor. Higher maternal pyrexia peaks may exacerbate adverse maternal and neonatal outcomes, emphasizing the importance of timely clinical intervention. NE% and CLR could serve as valuable indicators for identifying underlying causes and predicting peak maternal pyrexia during labor.

Early onset neonatal bloodstream infections in South African hospitals

BackgroundNeonatal sepsis is a leading cause of death in low- and middle- income countries (LMIC). Increasing antibiotic resistance in early onset (< 72 h of life) bloodstream infection (EO-BSI) pathogens in LMIC has reduced the effectiveness of the recommended empiric antibiotic regimen (ampicillin plus gentamicin).MethodsWe retrospectively analysed blood culture-confirmed EO-BSI episodes at nine neonatal units from three central and six peripheral hospitals in the Western Cape Province, South Africa between 1 January 2017 and 31 December 2018. Clinical and electronic laboratory records were reviewed to determine pathogen profile, empiric antibiotic coverage rates and factors associated with EO-BSI attributable mortality, stratified by hospital type.ResultsOf the 8252 blood culture specimens submitted for the investigation of suspected EO-BSI, 136 EO-BSI episodes yielding 141 pathogens were identified with an EO-BSI rate of 1.3 and 0.5 episodes/1000 live births at central and peripheral hospitals respectively. Preterm (93/136; 68.3%) and low birth weight (84/136; 61.8%) neonates were most affected. The predominant pathogens were Streptococcus agalactiae (46/136; 34%), Klebsiella pneumoniae (17/136; 13%), Listeria monocytogenes (11/136; 8%), Acinetobacter baumannii (11/136; 8%) and Escherichia coli (11/136; 8%). The empiric antibiotic (ampicillin plus gentamicin) coverage rate was 64% (95% CI 51–74) at central hospitals and 84% (95% CI 74–94) at peripheral hospitals. Neonates with Gram-negative EO-BSI and discordant empiric antibiotic therapy had almost four-fold and three-fold higher odds of death respectively.ConclusionPreterm and low birth weight neonates are most vulnerable to EO-BSI and have higher odds of death with Gram-negative pathogens and discordant empiric antibiotic therapy.

The immunogenetic basis of severe herpes simplex infections in neonates and children: a review.

Human herpes simplex virus (HSV) is a double stranded DNA virus with two distinct types, HSV-1 and HSV-2. The global burden of HSV is high with an estimated 2/3 of the adult population seropositive for at least one of these types of HSV. HSV rarely causes life-threatening disease in immunocompetent children and adults. However, in neonates and children with a developmentally immature immune system it can cause disseminated disease and herpes simplex encephalitis (HSE). Recent studies in children and neonates suggest that genetic risk-factors can contribute to severe HSV phenotypes in neonates and children. In particular, genetic defects in theToll Like Receptor 3 (TLR3) signaling pathway that attenuate the type I interferon response to HSV are being increasingly recognized in children with severe phenotypes of HSV. In this review, we discuss the epidemiology and immunological aspects of HSV disease in neonates and children and provide an in-depth review of the studies characterizing the role of inborn errors in the TLR3 pathway and other immune genes in HSV. We highlight the need for future research to identify the immunogenetic basis of severe or recurrent HSV disease in neonates and children. IMPACT: Review the epidemiology and phenotypes of herpes simplex virus (HSV) infection in neonates and children. Discuss the mechanisms of immunity against HSV highlighting the developmental vulnerability of neonates and infants to severe HSV disease. Explore in depth the genes and immune pathways that underlie genetic predisposition to severe HSV disease in neonates and children, and outline strategies for multi-disciplinary clinical evaluation of severe disease.

Ultrasensitive detection of six sepsis-associated proteins in neonatal saliva

Sepsis is a life-threatening condition that affects millions of newborns every year. Current diagnostic practices require painful, often repetitive, blood collections to isolate and culture the causative microorganism. Definitive return of results can take up to 5 days, exposing newborns to potentially unnecessary antibiotics. Developing a more rapid, non-invasive assessment of infectious status based upon host immune response provides an alternative diagnostic approach to infection screening. However, additional blood collection for multiplex quantification of inflammatory biomarkers in neonates remains prohibitive. Alternatively, saliva may serve as an informative biofluid, though detection of biologically relevant proteins in saliva remains challenging, with analyte concentrations 100 to 1000 times lower compared to blood. To address this challenge, we developed a panel of six ultra-sensitive single-molecule array (Simoa) assays for inflammatory biomarkers known to be associated with neonatal sepsis: serum amyloid A1 (SAA1), lipopolysaccharide-binding protein (LBP), chemokines CCL20, CXCL6, CXCL12; and the adipokine resistin. When these assays were tested on 40 neonatal salivary samples, we found that CXCL6 and CCL20 were significantly elevated in infected and septic neonates compared to those uninfected. The small volumes of fluid used (~10 μL saliva) and limited concentrations of these analytes in saliva (pg/mL) underscore the importance of ultra-sensitive measurements in the development of non-invasive diagnostics and reinforces the value of neonatal saliva as a viable sample matrix for monitoring infection. We hypothesize these assays could be useful in future diagnostic tests to discriminate between infected and uninfected neonates.

The diagnostic accuracy of umbilical cord procalcitonin in predicting early-onset neonatal infection.

To determine the threshold of umbilical cord blood procalcitonin for early-onset neonatal infection diagnosis. This prospective study was conducted on 126 neonates in the neonatal care unit of Hue University of Medicine and Pharmacy Hospital, Vietnam, from June 01, 2023 to August 31, 2024. All neonates showed signs at birth or risk factors for early-onset infection (EOI) and were divided into two groups: EOI group and non-EOI group. Umbilical cord blood samples were collected for procalcitonin analysis immediately after birth. The median procalcitonin (PCT) levels in umbilical cord blood were significantly higher in the EOI group (0.154 ng/ml [0.092-0.197]) compared to the non-EOI group (0.097 ng/ml [0.082-0.134]; p < 0.001). Receiver operating characteristic (ROC) curve determined the optimal threshold value of PCT of 0.142 ng/ml with an AUC 0.751 (95% CI: 0.661-0.841, p<0.001) in the total population. At this cut-off, the Se, Sp, PPV, and NPV were 68.2%, 76.8%, 61.2%, and 81.8%, respectively. The optimal cut-off value for preterm neonates was 0.122 ng/ml (AUC: 0.785, 95% CI: 0.658-0.911, p<0.001) corresponding a Se of 79.2%, Sp of 74.1%, PPV of 73.1%, and NPV of 80.0%. In term group, the optimal cut-off value was 0.150 ng/ml (AUC: 0.726, 95% CI: 0.583-0.860, p<0.01), with a Se of 60.0%, Sp of 80.4%, PPV of 52.2%, and NPV of 84.9%. Umbilical cord blood PCT concentration were elevated in neonates with EOI. PCT could be a valuable marker for the early diagnosis of EOI.

Interpretation of "Expert recommendations for the prevention of common respiratory viral infections in neonates": problems faced by respiratory syncytial virus infection in neonates

Neonates are susceptible to respiratory viral infections, with outbreaks reported in areas with a high population of neonates, such as postpartum care centers and neonatal wards. While specific antiviral drugs are currently available for influenza, symptomatic supportive treatment remains the primary approach for respiratory syncytial virus (RSV), making prevention particularly important. The article closely follows the "Expert recommendations for the prevention of common respiratory viral infections in neonates" and provides an in-depth interpretation of recent breakthroughs in RSV prevention. It discusses the physiological and immunological characteristics of neonates, the disease burden and transmission routes of RSV infection, the main clinical manifestations and long-term effects of RSV infection in neonates, as well as specific preventive measures against RSV and practical recommendations and prevention experiences for RSV from abroad to lay a foundation for RSV prevention and control in neonates in China.

Impact on Mental Health Problems during Coxsackievirus Outbreak in the General Public: A Review

Coxsackievirus group B (CVB), a member of the Picornaviridae family and enterovirus genus, poses risks during pregnancy due to its potential to cause severe fetal and neonatal infections. Transmission primarily occurs through fecal–oral routes, with infections peaking mostly in warmer months. Vertical transmission to the fetus can lead to conditions such as myocarditis, encephalitis, and systemic neonatal disease, presenting clinically as severe myocardial syndromes and neurological deficits. Diagnostic challenges include detecting asymptomatic maternal infections and conducting in utero assessments using advanced techniques like RT-PCR from amniotic fluid samples should be encouraged. Morbidity and mortality associated with congenital CVB infections are notable. Current treatments are limited to supportive care, with emerging therapies showing promise but requiring further study for efficacy. Mental health impact due to this virus results in speech development failure and autistic feature. Future research should aim to fill knowledge gaps in epidemiology, improve diagnostic capabilities, and develop targeted interventions to enhance maternal and fetal outcomes and other health issues due to this virus.

The basis of bacteriological safety in the neonatal intensive care unit (literature review)

Background. According to world statistics, 7% of patients out of 100 in high-income countries and 15% of patients out of 100 in low- and middle-income countries develop infections related to medical care. As follows from the report of the World Health Organization, one in four cases of hospital sepsis that occurred in the intensive care unit is caused by hospital strains. On average, one in ten of these patients has a hospital-acquired infection that is fatal. The high-risk group includes patients in intensive care units, including newborns. In 2023, 28973 cases of neonatal infections (including intrauterine infection) were registered in medical organizations of the Russian Federation. The highest rates of neonatal morbidity were recorded in the Sverdlovsk Region (42.2%), the Trans-Baikal Territory (33.0%), the Novosibirsk Region (26.0%), the Chelyabinsk Region (22.4%), the Krasnoyarsk Territory (21.8%) and the Irkutsk Region (21.3%). Thus, infection prevention and control strategies aimed at both patients and their environment are of paramount importance in neonatal intensive care units.Objective. To summarize current relevant data on the prevention of hospital infections in neonatal intensive care units.Materials and methods. A literature review was conducted using the MEDLINE database (PubMed) as of December 2024 using keywords and a filter: randomized controlled trial, meta-analysis, systematic review.Results. This review summarizes the main data on the prevention of hospital infections in neonatal intensive care units. According to the literature, ensuring bacteriological safety in relation to the development of hospital infections depends on many factors: hand hygiene of medical personnel, organization of venous access control, disinfection of medical equipment and premises, compliance with the rules of asepsis and antiseptics when performing invasive manipulations, the introduction of modern approaches in the care of premature infants.Conclusion. There are many tasks in the intensive care unit that require innovative strategies to ensure the safe care of premature newborns. Joint efforts to standardize the processing of specialized equipment, maintain the cleanliness of the environment, comply with vascular access care protocols, adequate hand hygiene, and the active introduction of parents into newborn care are an integral part of the program aimed at preventing nosocomial infections. Active cooperation between the neonatal intensive care unit and the epidemiological service of the institution will allow us to develop a rational policy for risk management and monitoring of hospital infections.

Streptococcus agalactiae in neonatology: detection strategies

Background. Group B streptococcus (Streptococcus agalactiae, SGV) remains the main cause of neonatal sepsis and meningitis, despite a marked decrease due to the use of intranatal antibiotic prophylaxis. At the same time, delays in the detection and treatment of neonatal infections can cause serious consequences and, in some cases, the death of a newborn, on the other hand, unnecessary use of antibiotics also has harmful consequences (changes in the normal microbiota of a newborn, the development of antimicrobial resistance, etc.). At the same time, laboratories are constantly faced with the task of improving diagnostic approaches for the rapid and correct identification of newborns with infection.The purpose of the study. To analyze the effectiveness, efficiency and timing of the results of bacteriological examination in neonatal sepsis and meningitis caused by Streptococcus agalactiae to determine the best diagnostic strategy.Material and methods. In the period from January to November 2024, the case histories of 10 newborns with positive hemoculture for Streptococcus agalactiae were analyzed. Blood samples were taken under aseptic conditions according to the standard protocol. The identification of microorganisms was carried out by 2 methods: 1 — by standard subcultivation on nutrient cups and 2 — directly from positive vials using MALDI-TOF MS technology on a Vitek MS analyzer (BioMerieux, France) using the in-house method.Results. The average time from the moment of sampling to placement in the hemocultivation device (A) was 13.1±7.4 hours, the average growth time of the microorganism, i.e., to a positive signal (B) was 6.7± 3.0, the average time for identification of the pathogen from a blood vial (C) was 20.2±13.1, the average sample turnover time in the laboratory (from the collection of the material to the issuance of the identification result to the clinician — D) was 42.0 ± 12.0 hours. When using the accelerated identification method directly from a positive vial, the average time C was 12.5 hours, D — 36.3 hours.Conclusions. The use of an accelerated technique for the cultural detection of OHS in hemocultures of newborn children allowed to reduce the time of identification of the pathogen in a positive blood culture by 17.5 hours from 30 hours to 12.5 (more than 2 times), and the total time from obtaining the biomaterial to making a decision by the attending physician was reduced by 14 hours (from 50 hours to 36), i.e. almost 1.5 times.

Analysis of Salivary Cytokines in Retinopathy of Prematurity.

This cohort study aimed to establish a correlation between salivary cytokines and retinopathy of prematurity (ROP) in premature neonates. Additionally, we sought to identify a minimally invasive method for cytokine detection in this population. We recruited premature neonates born at less than 34 weeks gestational age (GA), with no history of maternal or neonatal infections. Salivary samples were collected on their first (D1) and seventh (D7) days of life, and cytokine levels were measured using the MILLPLEXMAP Human multiplex assay. A total of 125 neonates were included in the study, categorized into two groups based on the severity of ROP: None to Mild and Moderate to Severe. The salivary levels of interleukin (IL)-6, IL-8, vascular endothelial growth factor (VEGF), and tumor necrosis factor (TNF)-α on D1 and D7 were significantly higher in the Moderate to Severe ROP group compared to the None to Mild ROP group (p = 0.005, 0.004, 0.026, 0.018, 0.001, 0.007, 0.025, and 0.002, respectively). After adjusting for GA, the levels of IL-6 and VEGF on D7 were significantly elevated in the Moderate to Severe ROP group compared to the None to Mild ROP group (p = 0.024 and 0.016, respectively). This study establishes a novel, non-invasive method for the early prediction of ROP in premature neonates by correlating salivary cytokine levels in early life with the subsequent development of ROP.