Infections In Newborns Research Articles

Emetic and Diarrheal Toxins Detection and Typing of Bacillus cereus in Food and Human Milk in Italy

Abstract Background Bacillus cereus, responsible for 1.4%-12% of all food poisoning outbreaks worldwide, produces several virulence factors, including toxins which are mainly found in raw and processed food, as starch-based and dairy products. It can cause two types of gastrointestinal diseases: emetic form, with nausea and vomiting which appears as soon as after food consumption, and diarrheal form, with abdominal cramps, which occurs after 8-16 h. Moreover, B. cereus is the most common pathogen in pasteurized human milk, a precious aid in neonatal care. The aim of this study was to investigate the prevalence of B. cereus toxins kinds using WGS and to detect in silico sequence types (ST) in isolates from food and human milk. Methods During B. cereus routine surveillance in Lombardy (Italy), a total of 41 isolates were collected from food (n = 16) and donor breast milk (n = 25) between 2022-2023, and then analysed with WGS. Libraries were prepared using the Illumina DNA Prep Kit and WGS was performed on the Illumina MiSeq. Using the BTyper tool, for each sample emetic and diarrheal toxins were identified and ST was assigned. Results All 41 isolates had at least one diarrheal toxin, specifically the nonhemolytic enterotoxin was found in all the isolates, the cytotoxin K was detected in 37% of isolates, and the hemolysin BL in 32%. Instead, the emetic toxin was found in only 3 samples isolated from food. Using in silico MLST, different STs were found with a higher prevalence of ST26 and ST144. Conclusions Diarrheal toxins were detected in all samples underling that B. cereus food infections play an important role in the public health and in the food industry. These aspects are even more significant when the pathogen is isolated from human breast milk, as it can induce severe infections in newborns. Key messages • The presence of B. cereus toxins in food and human milk underlines the importance of its ongoing monitoring and analysis. • Human breast milk has a high risk of B. cereus contamination which is the most frequent cause for its discarding.

CORRELATION OF C-REACTIVE PROTEIN AND BLOOD CULTURE IN NEONATAL SEPSIS AT INTEGRAL INSTITUTE OF MEDICAL SCIENCES AND RESEARCH, HOSPITAL LUCKNOW (UTTAR PRADESH)

Objective: Neonatal sepsis is a clinical condition of bacteremia characterized by systemic signs and symptoms of infection in children under 4 weeks of age. It involves systemic infections in newborns, including septicemia, meningitis, pneumonia, arthritis, osteomyelitis, and urinary tract infections. C-reactive protein (CRP) is an abnormal β-globulin produced by the liver during any inflammatory process. The gold standard method to diagnose neonatal sepsis is blood culture; however, it is time-consuming and requires a well-equipped laboratory and trained personnel. To study the correlation between CRP and blood culture in neonatal sepsis. Methods: The present study was a retrospective study conducted at the Integral Institute of Medical Sciences and Research, Hospital Lucknow. (UP) All the indoor neonates attending at the Integral Institute of Medical Science and Research Hospital who’s both parameters, CRP as well as blood culture were noted in the microbiology department register during my study period. In the blood culture, samples were collected aseptically and processed by either conventional or automated blood culture methods. CRP estimation was done by a latex agglutination card test. CRP was reported as positive if agglutination particles were seen. Results: CRP positivity rate: out of 235 samples, 72 (30.64%) were positive and 163 (69.36%) were negative. Blood culture positivity rate: out of 118 samples, 71 (60.17%) cases were culture positive and 47 (39.83%) were negative. After comparison of CRP samples with blood culture samples, 90 samples were tested for both blood culture and CRP, and the babies ages were under 4 weeks. Conclusion: So from our study, we are concluding that blood culture is the gold standard method for the diagnosis of neonatal sepsis, and although we can use CRP as the screening method, this test is not specific enough to be relied upon as the only indicator.

A study on bacteriological profile in suspected cases of neonatal sepsis and its correlation with various biomarkers in the rural population of a university hospital

ABSTRACT Introduction: Neonatal sepsis is an infection in newborns that may be caused by bacteria, fungi, or viruses and has a high death and morbidity rate. The clinical presentation of sepsis may be rather general, making it challenging to make a diagnosis. While blood culture is the most accurate method to diagnose sepsis, it is also time-consuming. Because of this, it is crucial to locate other biomarkers like C-reactive protein (CRP), high sensitive C-reactive protein (hs-CRP), and procalcitonin (PCT) that may aid in early identification. Aim: To learn about the bacterial composition of suspected cases of neonatal sepsis in a tertiary care hospital in western Uttar Pradesh and how that composition relates to the biomarkers CRP, hs-CRP, and PCT Materials and Methods: Hundred people who fulfilled the study’s inclusion criteria were included. All neonatal venous blood samples have been obtained after receiving written informed permission from either parent. The conventional method was used to perform the blood culture. The ELISA technique has been used to determine hs-CRP along with serum PCT levels, while the latex agglutination test was utilized for CRP detection. Result: A total of 100 cases were enrolled, 78% presented within 3 days of birth. Blood culture was positive in 33 neonates (33%). There were 17 Gram-positive, 15 Gram-negative, and in all 2 cases with poly bacterial culture. CRP positivity rate was significantly higher in culture positive (57.6%) as compared to culture-negative neonates (25.4%). It was shown that a CRP >6 mg/l level was sensitive at 57.6% and specific at 74.6%. hs-CRP has a 100% sensitivity and 47.8% specificity. The PCT’s sensitivity was 69.7%, whereas its specificity was 89.6%. Conclusion: PCT is more specific for detecting sepsis, but hs-CRP is more sensitive than CRP. The combination of PCT along with hs-CRP has a negative predictive value and high sensitivity compared to other markers. Thus, the most accurate predictors of neonatal sepsis would be a combination of factors.

Anti bacterial function of secreted human FABP3

FABP3 belongs to a large family of cytoplasmic fatty acid binding proteins that are expressed in a tissue-specific manner. It is predominantly expressed in breast, muscle and heart. During our exploratory studies on the role of FABP3 in tumorigenesis and our consequent attempts to study the molecular mechanism responsible for the oncogenic potential of FABP3, we came across an unexpected role of FABP3 as an anti-bacterial protein. Presence of the protein was detected in culture media of cell lines stably over-expressing human FABP3. Conditioned medium from these FABP3 over-expressing cells exerted a distinct anti-bacterial activity against E. coli. Our results indicate that binding of FABP3 to the bacterial cell surface contributes to its anti-bacterial activity. Incubation of E. coli bacterial cells with FABP3 protein led to disruption of the physical integrity of bacterial cell membrane causing leakage of cellular components. Further, in silico analysis predicted strong binding of FABP3 to the antibiotic binding sites on the bacterial ribosome. Interestingly, we found that FABP3 is a naturally occurring secretory protein present in milk in abundance as confirmed by western blot and ELISA. Thus, our experimental data together with in silico analysis suggests that FABP3 is secreted in milk, has an anti-bacterial function, shows activity against E. coli by disrupting bacterial membrane and targeting the ribosome, and may play a protective role against bacterial infection in newborns.

Identification of staphyloxanthin and derivates in yellow-pigmented Staphylococcus capitis subsp. capitis.

Staphylococcus capitis naturally colonizes the human skin but as an opportunistic pathogen, it can also cause biofilm-associated infections and bloodstream infections in newborns. Previously, we found that two strains from the subspecies S. capitis subsp. capitis produce yellow carotenoids despite the initial species description, reporting this subspecies as non-pigmented. In Staphylococcus aureus, the golden pigment staphyloxanthin is an important virulence factor, protecting cells against reactive oxygen species and modulating membrane fluidity. In this study, we used two pigmented (DSM 111179 and DSM 113836) and two non-pigmented S. capitis subsp. capitis strains (DSM 20326T and DSM 31028) to identify the pigment, determine conditions under which pigment-production occurs and investigate whether pigmented strains show increased resistance to ROS and temperature stress. We found that the non-pigmented strains remained colorless regardless of the type of medium, whereas intensity of pigmentation in the two pigmented strains increased under low nutrient conditions and with longer incubation times. We were able to detect and identify staphyloxanthin and its derivates in the two pigmented strains but found that methanol cell extracts from all four strains showed ROS scavenging activity regardless of staphyloxanthin production. Increased survival to cold temperatures (-20°C) was detected in the two pigmented strains only after long-term storage compared to the non-pigmented strains. The identification of staphyloxanthin in S. capitis is of clinical relevance and could be used, in the same way as in S. aureus, as a possible target for anti-virulence drug design.

Resistance Rates of Streptococcus agalactiae Strains Isolated from Urine Samples to Various Antibiotics

Aim: Group B Streptococcus (GBS), also known as Streptococcus agalactiae, are Gram-positive, encapsulated bacteria found in the normal human gastrointestinal and urogenital flora. A wide variety of infectious diseases can cause urogenital system infections in newborns, elderly people, immunocompromised people, pregnant women, and adults. In this study, we aimed to inform clinicians about the agents that can be used in intrapartum antibiotic prophylaxis by examining the antibiotic susceptibility of GBS strains isolated from urine samples from the Gynecology and Obstetrics Clinic in our laboratory.
 Material and Methods: Isolates of the S. agalactiae isolated from a total of 222 urine samples from the Gynecology and Obstetrics Clinic that came to our Medical Microbiology laboratory between January 2022 and December 2022 were included and the data of these isolates were evaluated retrospectively. The clinical samples that came to our laboratory were inoculated on Sheep blood agar medium and incubated at 37°C for 18-24 hours. Quantitatively seeded urine culture ≥104 CFU/ml grown bacteria was considered a uropathogenic. Urogenital skin flora element or three and more different types of bacteria growing cultures as contamination evaluated. 
 Results: Due to the group selected as the sample, 100% of the patients were female. The age range of the patients ranged from 12 to 72, and the mean age was calculated as 30.16. All GBS isolates were susceptible to penicillin, linezolid, trimethoprim-sulfamethoxazole, tigecycline, teicoplanin, and vancomycin. 
 Conclusion: Penicillin resistance was not found in our study. However, resistant strains were detected in erythromycin, clindamycin, and levofloxacin, which stand out as other options in cases where penicillin cannot be used.

Early Diagnostic Markers of Late-Onset Neonatal Sepsis.

Early diagnosis of nosocomial infections in newborns is a great challenge, because in the initial phase of systemic infection, clinical symptoms are often non-specific, and routinely used hematological markers are not sufficiently informative. The aim of this study was to determine the potential of early inflammatory markers to diagnose late-onset neonatal sepsis-procalcitonin (PCT), interleukin 6 (IL-6), interleukin 8 (IL-8) and endocan (ESM-1). A prospective clinical-epidemiological study was conducted in a third-level NICU in Pleven, Bulgaria. Patients with suspected late-onset sepsis and healthy controls were tested. A sandwich ELISA method was used to measure the serum concentrations of biomarkers. Sixty newborns were included, of which 35% symptomatic and infected, 33.3% symptomatic but uninfected and 31.7% asymptomatic controls. The mean values of PCT, IL-6, I/T index and PLT differ significantly in the three groups. For ESM-1, IL-8 and CRP, the difference was statistically insignificant. The best sensitivity (78%) and negative predictive value (84%) was found for IL-6. The combinations of PCT + IL-6 and PCT + IL-6+ I/T+ PLT showed very good diagnostic potential. The introduction into the routine practice of indicators such as PCT and IL-6 may provide an opportunity to promptly optimize the diagnostic and therapeutic approach to LOS.

Loop-mediated isothermal amplification assay for screening congenital cytomegalovirus infection in newborns

Congenital cytomegalovirus (CMV) infection is a common cause of sensorineural hearing loss and neurodevelopmental impairment in newborns. However, congenital CMV infection cannot be diagnosed using samples collected more than 3 weeks after birth because testing after this time cannot distinguish between congenital infection and postnatal infection. Herein, we developed a robust loop-mediated isothermal amplification (LAMP) assay for the large-scale screening of newborns for congenital CMV infection. In contrast to conventional quantitative polymerase chain reaction (qPCR), which detects CMV within a dynamic range of 1.0 × 106 to 1.0 × 102 copies/μL, our quantitative LAMP assay (qLAMP) detects CMV within a dynamic range of 1.1 × 108 to 1.1 × 103 copies/μL. Moreover, the turnaround time for obtaining results following DNA extraction is 90 min in qPCR but only 15 min in qLamp. The colorimetric LAMP assay can also detect CMV down to 1.1 × 103 copies/μL within 30 min, irrespective of the type of heat source. Our LAMP assay can be utilized in central laboratories as an alternative to conventional qPCR for quantitative CMV detection, or for point-of-care testing in low-resource environments, such as developing countries, via colorimetric naked-eye detection.Key points• LAMP assay enables large-scale screening of newborns for congenital CMV infection.• LAMP allows colorimetric or quantitative detection of congenital CMV infection.• LAMP assay can be used as a point-of-care testing tool in low-resource environments.

Antenatal corticosteroids: an updated assessment of anticipated benefits and potential risks

Antenatal steroid therapy is increasingly central to the obstetric management of women at imminent risk of preterm birth. For women likely to deliver between 24 and 34 weeks’ gestation, antenatal steroid therapy is standard of care, conveying sizable benefits and few risks in high-resource environments when appropriately targeted.Recent studies have focused on antenatal steroid use in periviable and late preterm populations, and in term cesarean deliveries. As a result, antenatal steroid therapy has now been applied from 22 weeks, to those delivered at 39+6 weeks estimated gestational age. There is also an increased appreciation that the vast majority of randomized control data informing the use of antenatal steroids derive from predominantly high-resource, Caucasian populations. Accordingly, a sizable amount of work has recently been undertaken to test if and how to safely use antenatal steroids in low- and middle-resource environments, wherein the often-high rates of preterm birth make these low cost, easily administered interventions an attractive proposition.It is likely underappreciated by the obstetric and neonatal communities that the overall efficacy of antenatal steroid therapy is highly variable (including when preterm risk is accurately assessed), that the treatment regimens employed are largely arbitrary, dosing is supra-pharmacological for effect, and the extent to which the benefit to risk balance is significantly and differentially modified by gestation. It is also very likely that the patients consented to receive these treatments are similarly unaware of the complex balance of potential benefits and harms. Although a small number of follow-up studies present a generally benign picture of long-term antenatal steroid risk, several large, population-based retrospective studies have identified associations between antenatal steroid use, childhood mental disease and newborn infections that warrant urgent attention.Of particular contemporary importance is emergent efforts to optimize antenatal steroid regimens based on the pharmacokinetics and pharmacodynamics of the agents themselves, the need for better targeting of these potent drugs, and clear articulation of the potential benefits and harms of antenatal steroid use at differing stages of pregnancy, and in different delivery contexts.

A systematic review on biological and medicinal properties of Ehretia rigida (Thunb.) Druce (Ehretiaceae) in Southern Africa

Wild plants are widely utilized as important sources of traditional medicines and food. Ehretia rigida (Thunb.) is one such plant species that occurs naturally in southern Africa and different parts of the plant have nutritional, cultural, and pharmaceutical importance. The current study is aimed at providing information on the medicinal and biological properties of E. rigida. The current review assessed the existing literature on the biological properties and medicinal uses of the plant. The study revealed that the leaves, twigs, stems, bark and roots of the plant are mainly used for ritual purposes, as traditional medicines for infertility, headache, abdominal pains, chest pains, pain, skin cuts, sprained joints, newborn baby infections, a good-luck charm, fire-making and rain-making ceremonies, warding-off enemies and dangerous animals and as ethnoveterinary medicine. The phytochemical evaluation of the species showed that it is characterized by allantoin, ?-amyrin, ?-amyrin, ?avonoids, phenolics, saponins, tannins, ?-sitosterol and 1-triacontanol. The pharmacological properties of different crude extracts demonstrated anticholinesterase inhibition, antifungal, antibacterial, antidiabetic, anti-inflammatory, and antioxidant properties. This review highlights the pharmaceutical and health benefits of E. rigida in different countries of southern Africa. Therefore, detailed ethnopharmacological evaluations of the species focusing on phytochemistry, pharmacological properties, toxicological evaluations, and in vivo and clinical research investigations are recommended.

Correlates of postnatal human cytomegalovirus transmission in term babies in the first year.

Postnatal human cytomegalovirus (HCMV) infection in newborns is well characterized for preterm infants but less so for term infants. We sought to analyze the rates and routes of HCMV transmission in full-term infants during the first year of life. A cohort of 120 HCMV seropositive mothers and their 122 newborns were tested after delivery for HCMV-DNA shedding in different bodily fluids. Postnatal HCMV infection was defined as the detection of >2.5 × 102 HCMV-DNA copies/mL in infants' saliva swabs. Maternal neutralizing antibody serum titer, HCMV-specific T-cell response, and HCMV glycoprotein B immunoglobulin G on breastmilk were analyzed. HCMV shedding was detected in 67 of 120 mothers (55.8%), and 20 of 122 infants (16.4%) developed HCMV infection within the first 3 months of life. Six additional infants were infected during the first year, for a postnatal infection rate of 21.3%. Viral shedding was more frequent in breastmilk than saliva, urine, and vaginal secretions, and the mothers of infected infants showed higher levels of HCMV-DNA in milk. No association was found between the antibody levels in serum or milk and maternal viral shedding, whereas a slightly lower frequency of HCMV-specific CD4+ T-cells with long-term memory phenotype was observed in women with HCM-DNA-positive milk. About one out of five infants develop HCMV infection within the first year of life. Breastmilk appears the major route of transmission of the infection, maternal saliva has a minor role whereas the role of vaginal secretions is negligible.

Effect of Intrapartum Azithromycin vs Placebo on Neonatal Sepsis and Death A Randomized Clinical Trial

ABSTRACT Sepsis is a leading cause of neonatal mortality, and rates have not decreased in recent years despite medical advances. Azithromycin has been shown in previous research to be effective in reducing infection and sepsis; in particular, a recent study showed that administration of the drug during labor reduced gram-positive bacteria over the next 4 weeks, along with reduced disease in mothers and newborns. This study was designed to assess the effectiveness of azithromycin administered during labor in reducing instances of neonatal sepsis and mortality. The primary outcome for this study was neonatal sepsis or death within the first 28 days of life. Deaths that were identifiably due to severe birth asphyxia, low birth weight, and severe congenital malformations were excluded. Secondary outcomes included neonatal sepsis, neonatal mortality, culture-confirmed sepsis, fever, skin infections, bacterially confirmed skin infections, conjunctivitis, umbilical infection/omphalitis, malaria, prescribed antibiotics, and hospitalization. Secondary outcomes for parents included postpartum sepsis, bacterially confirmed postpartum sepsis, mastitis, malaria, puerperal fever, prescribed antibiotics, hospitalization, and mortality. The final analysis included 11,625 parents and 11,783 neonates; baseline characteristics between the azithromycin and placebo groups were not significantly different. Of the total sample, 225 instances of neonatal sepsis or death occurred. The incidence of either mortality or sepsis was similar between groups (odds ratio [OR], 1.06; 95% confidence interval [CI], 0.80–1.38; P = 0.70), as well as the individual outcomes of mortality (OR, 1.05; 95% CI, 0.70–1.60; P = 0.80) and sepsis (OR, 1.02; 95% CI, 0.74–1.40; P = 0.92). Incidence of neonatal skin infections (P < 0.001), bacterially confirmed skin infections (P = 0.003), and need for antibiotics (P < 0.001) were all significantly reduced in the azithromycin group. Azithromycin reduced instances of both mastitis (P = 0.04) and puerperal fever (P = 0.04), but there were no other significant differences between groups. These results indicate no effect of azithromycin on neonatal sepsis or mortality. There were reductions in some instances of infection in both parents and newborns, specifically newborn skin infections, but there was no effect on the primary outcome. These results are in contrast to the previous proof-of-concept trial that showed azithromycin to reduce the amount of gram-positive bacteria carried by mothers and infants. Recent studies from different countries have found some conflicting results in longer-term outcomes, but the differing time periods limit comparison of results. This study was limited by underestimation of incidence of infections due to follow-up design, as well as slight differences between the 2 countries involved in the study. Overall, the results of this analysis do not support a change in clinical practice to introduce azithromycin to prevent neonatal sepsis and mortality.

Viral Respiratory Infections in Newborns After The Pandemic

İnsanlarda ‘severe acute respiratory syndrome coronavirus 2’ (SARS-CoV-2) olarak adlandırılan yeni coronavirüs suşuna bağlı enfeksiyonlar ilk olarak 2019 yılında görülmeye başlamış ve Mart 2020 yılında dünya sağlık örgütü tarafından COVİD-19 pandemisi kabul edilmiştir. Bununla birlikte bireysel, toplumsal ve ülkesel bazda farmakolojik olmayan müdahaleler hayatımıza girmiş ve pandemi yavaşlatılmaya çalışılmıştır. Bu farmakolojik olmayan müdahaleler ile sadece SARS-CoV-2 değil, diğer solunum sistemini tutan viral ajanlarda etkilenmiştir. Özellikle küçük çocuklar ve yenidoğanlarda ciddi alt solunum yolu enfeksiyonu yapan başta respiratuvar sinsityal virüs, rinovirüs ve respiratuvar enterovirüsler olmak üzere diğer tüm virüslerin toplumda görülmesinde ve enfeksiyon şiddetinde değişiklikler ortaya çıkmıştır. Bu derlemede özellikle respiratuvar sinsityal virüs, influenza virüs, rinovirüs ve respiratuvar enterovirüsler, adenovirüs, insan metapnömovirüs ve parainfluenza üzerinde durularak pandemi öncesi, pandemi sırası ve pandemi sonrasında görülme sıklıkları ve yenidoğan üzerindeki farklılaşan etkilerine değinilmiştir. COVID-19 pandemisi sırasında elde edilen bu bulgular gelecekte başka bir virüsün yol açabileceği olası bir pandemi yönetiminde ışık tutucu olacaktır.

Effect of probiotics on mother-to-neonate vertical transmission of group B streptococci: A prospective open-label randomized study

Group B Streptococci (GBS) are common vaginal bacteria found in 20-30% of pregnant women and a significant cause of invasive infections in newborns. Recently, attention has been focused on the efficacy of probiotics during the perinatal period. However, the effect of probiotic intake on the mother-to-child transmission (MTCT) of GBS remains unknown. Pregnant women with positive GBS results from vaginal and rectal swab cultures at 35-37 weeks of gestation were randomly assigned to the probiotic group or the control group in an open-label manner at the Department of Obstetrics and Gynecology, San-ikukai Hospital, Tokyo, Japan. The probiotic group received Lactobacillus reuteri during antenatal checkups from 35 to 37-week gestation to 1 month after delivery. Rectal swabs were obtained from the newborns at 5 days and at 1 month of age. Whole-genome sequencing was performed to test for GBS strains in the mother, whose newborn carried GBS at the 1-month checkup. Multi-locus sequence typing and single nucleotide polymorphism analyses were performed to identify MTCT. Overall, 67 mother-infant pairs were included, with 31 in the probiotic group and 36 in the control group. The positivity rate of GBS in newborns at 1 month of age was 10% (n=3) in the probiotic group and 28% (n=10) in the control group. In newborns carrying GBS at 1 month of age, genetic analysis revealed that the MTCT rate was 6% in the probiotic group and 22% in the control group, although the difference was not statistically significant (p=0.0927). No statistically significant difference was found; however, the consumption of L. reuteri by women with GBS-positive pregnancies may inhibit the MTCT of GBS.

On the exact reproduction number in SIS epidemic models with vertical transmission

This paper proposes a bi-variate competition process to describe the spread of epidemics of SIS type through both horizontal and vertical transmission. The interest is in the exact reproduction number, mathcal{R}_{mathrm{{exact}},0}, which is seen to be the stochastic version of the well-known basic reproduction number. We characterize the probability distribution function of mathcal{R}_{mathrm{{exact}},0} by decomposing this number into two random contributions allowing us to distinguish between infectious person-to-person contacts and infections of newborns with infective parents. Numerical examples are presented to illustrate our analytical results.

The Use of Saliva Samples to Test for Congenital Cytomegalovirus Infection in Newborns: Examination of False-Positive Samples Associated with Donor Milk Use.

A universal screening research study was conducted in six hospitals to identify the clinical sensitivity of polymerase chain reaction (PCR) testing on newborn dried blood spots (DBSs) versus saliva specimens for the diagnosis of congenital cytomegalovirus (cCMV). CMV DNA positive results from DBSs or saliva were confirmed with urine testing. Findings of several false-positive (FP) saliva PCR results prompted an examination of a possible association with donor milk. Documentation of the frequency of positive saliva results, including both true-positive (TP) and FP status from clinical confirmation, occurred. The frequency of donor milk use was compared for TP and FP cases. Of 22,079 participants tested between 2016 and 2022, 96 had positive saliva results, 15 were determined to be FP, 79 TP, and 2 were excluded for incomplete clinical evaluation. Newborn donor milk use was identified for 18 (19.14%) of all the positive saliva screens. Among the 15 FPs, 11 (73.33%) consumed donor milk compared to 7 of the 79 TPs (8.8%) (OR 28.29, 95% CI 7.10-112.73, p < 0.001). While milk bank Holder pasteurization inactivates CMV infectivity, CMV DNA may still be detectable. Due to this possible association, screening programs that undertake testing saliva for CMV DNA may benefit from documenting donor milk use as a potential increased risk for FP results.

ИНФЕКЦИИ МОЧЕВОЙ СИСТЕМЫ У ДЕТЕЙ, РОДИВШИХСЯ НЕДОНОШЕННЫМИ: СЛОЖНОСТИ ДИАГНОСТИКИ И ЛЕЧЕНИЯ

Urinary tract infections are a common problem in premature newborns, but its diagnosis is of certain difficulties due to the non-specific clinical picture and laboratory parameters, which in its turn complicates timely treatment and can therefore lead to the development of unfavorable complications. The article provides a bibliographical review on the issue and discusses the modern approaches to the diagnosis and treatment of urinary tract infections in premature newborns.

Directional immobilization of phage on the palladium-based nanozyme for colorimetric detection of Cronobacter sakazakii in powdered infant formula

Cronobacter sakazakii in powdered infant formula (PIF) can cause infections in newborns that are life-threatening. Establishing a High-performance evaluation method for C. sakazakii in the PIF is urgently needed. In this study, a chromogenic system based on phage-directed immobilized nanozyme for colorimetric measurement of C. sakazakii in PIF was constructed. Initially, our acquired phage EspYZU15 was electrostatically immobilized on the surface of a palladium-based nanozyme to produce EspYZU15 directionally immobilized Pd (EspYZU15@Pd). EspYZU15@Pd possesses outstanding peroxidase-like properties, catalyzing the chromogenic reaction of 3,3′,5,5′-tetramethylbenzidine (TMB) in the presence of H2O2. The ability of EspYZU15@Pd to recognize and trap host bacteria allows C. sakazakii to specifically inhibit the TMB chromogenic process catalyzed by EspYZU15@Pd. Based on this detection strategy, a visual quantification method for C. sakazakii ranging from 3.2 × 102 to 3.2 × 107 CFU mL−1 was developed, yielding a low limit of detection (LOD) of 3.6 × 101 CFU mL−1. This method was able to successfully detect C. sakazakii in PIF, with outstanding recoveries ranging from 95.8% to 104.9%. These characteristics indicate that the EspYZU15@Pd-based chromogenic system has considerable promise for the colorimetric determination of C. sakazakii in PIF.

Serostatus of echovirus 11, coxsackievirus B3 and enterovirus D68 in cord blood: The implication of severe newborn enterovirus infection.

Maternal transplacental antibody is an important origins of passive immunity against neonatal enterovirus infection. Echovirus 11 (E11) and coxsackievirus B3 (CVB3) are important types causing neonatal infections. There were few investigations of enterovirus D68 (EVD68) infection in neonates. We aimed to investigate the serostatus of cord blood for these three enteroviruses and evaluate the factors associated with seropositivity. We enrolled 222 parturient (gestational age 34-42 weeks) women aged 20-46 years old between January and October 2021. All participants underwent questionnaire investigation and we collected the cord blood to measure the neutralization antibodies against E11, CVB3 and EVD68. The cord blood seropositive rates were 18% (41/222), 60% (134/232) and 95% (211/222) for E11, CVB3 and EVD68, respectively (p<0.001). Geometric mean titers were 3.3 (95% CI 2.9-3.8) for E11, 15.9 (95% CI 12.5-20.3) for CVB3 and 109.9 (95% CI 92.4-131.6) for EVD68. Younger parturient age (33.8±3.6 versus 35.2±4.4, p=0.04) was related to E11 seropositivity. Neonatal sex, gestational age and birth body weight were not significantly different between the seropositive group and the seronegative group. Cord blood seropositive rate and geometric mean titer of E11 were very low, so a large proportion of newborns are susceptible to E11. The circulation of E11 was low after 2019 in Taiwan. A large cohort of immune naïve newborns existed currently due to lack of protective maternal antibodies. It is imminent to monitor the epidemiology of neonates with enterovirus infections and strengthen the relevant preventive policies.

Abemaciclib restricts HCMV replication by suppressing pUL97-mediated phosphorylation of SAMHD1

Human cytomegalovirus (HCMV) is a herpesvirus that causes life-threatening infections in newborns or immunosuppressed patients. For viral replication, HCMV establishes a network of cellular interactions, among others cyclin-dependent kinases (CDK). Furthermore, HCMV encodes pUL97, a viral kinase, which is a CDK-homologue. HCMV uses pUL97 in order to phosphorylate and thereby antagonize SAMHD1, an antiviral host cell factor. Since HCMV has several mechanisms to evade restriction by SAMHD1, we first analyzed the kinetics of SAMHD1-inactivation and found that phosphorylation of SAMHD1 by pUL97 occurs directly after infection of macrophages. We hence hypothesized that inhibition of this process qualifies as efficient antiviral target and FDA approved CDK-inhibitors (CDKIs) might be potent antivirals that prevent the inactivation of SAMHD1. Indeed, Abemaciclib, a 2nd generation CDKI exhibited superior IC50s against HCMV in infected macrophages and the antiviral activity largely relied on its ability to block pUL97-mediated SAMHD1-phosphorylation. Altogether, our study highlights the therapeutic potential of clinically-approved CDKIs as antivirals against HCMV, sheds light on their mode of action and establishes SAMHD1 as a valid and highly potent therapeutic target.