Infection In Young Infants Research Articles

Rotavirus gastroenteritis and weather.

During 5.5 years of a study in Washington, D.C., hospitalizations of children for rotavirus gastroenteritis tended to be more common after a month of cold or dry weather than after a corresponding calendar month of warm or wet weather. Overall, there were 84% more (178 versus 97) inpatients with rotavirus gastroenteritis after a set of relatively colder individual months taken as a group than after an equal number of warmer corresponding calendar months taken as a group. Comparable differences were not seen with nonrotavirus gastroenteritis patients. There also were 45% more rotavirus hospitalizations after the set of months with the least depth of precipitation compared with the set of corresponding calendar months with the greatest depth of precipitation. Rotavirus infection in young infants, the children least likely to be directly exposed to outdoor conditions, showed some of the most marked weather-associated effects. These findings suggest that weather-related low indoor relative humidity and indoor crowding may be key factors in the epidemiology of rotavirus disease.

Urinary Tract Infections in Young Infants

The clinical and laboratory features of urinary tract infections in 100 infants aged 5 days to 8 months are presented. Of the patients in the first three months of life 75% were boys, and of infants aged 3 to 8 months only 11% were boys; 95% of the infants were uncircumcised. Sepsis was documented in 31% of neonates, 21% of infants aged 1 to 2 months, 14% of those aged 2 to 3 months, and 5.5% of infants greater than 3 months of age. Roentgenographic abnormalities of the urinary system were found in 45% of female and 7% of male infants. All infants responded promptly to antimicrobial therapy. The possible factors related to the predominance of male infants with urinary tract infections in the first three months of life are discussed.

Urinary Tract Infections in Young Infants

The clinical and laboratory features of urinary tract infections in 100 infants aged 5 days to 8 months are presented. Of the patients in the first three months of life 75% were boys, and of infants aged 3 to 8 months only 11% were boys; 95% of the infants were uncircumcised. Sepsis was documented in 31% of neonates, 21% of infants aged 1 to 2 months, 14% of those aged 2 to 3 months, and 5.5% of infants greater than 3 months of age. Roentgenographic abnormalities of the urinary system were found in 45% of female and 7% of male infants. All infants responded promptly to antimicrobial therapy. The possible factors related to the predominance of male infants with urinary tract infections in the first three months of life are discussed.

Protection of infants from infection with influenza A virus by transplacentally acquired antibody.

Transplacentally acquired antibody to influenza A virus was measured by a microneutralization test and a radioimmunoprecipitation assay in cord blood obtained from infants at a large urban county hospital in 1975-1978. Random samples tested before epidemic periods were a measure of susceptibility of the population. Twenty-six infants from whom cord sera were available had culture-documented infections with influenza A/Victoria (H3N2) virus when younger than four months. The direct correlation between age at the time of infection and level of antibody measured in cord serum (P less than 0.002) suggested a protective effect of transplacentally acquired antibody. None of fourteen acute-phase serum specimens obtained early in the course of culture-positive infections of young infants had detectable antibody to influenza A viral hemagglutinin by the sensitive radioimmunoprecipitation test. Because passively transferred maternal antibody to influenza virus may prevent symptomatic infection in young infants, vaccination of pregnant women could be beneficial.

Apnea associated with respiratory syncytial virus infection in young infants

The hospital charts of 274 infants under 6 months of age with culture-proved respiratory syncytial virus infections were reviewed. Fifty-six infants (20.4%) demonstrated apnea in association with RSV infection. Predisposing factors significantly correlated with apnea included premature birth and young chronologic age at the time of virus infection. The clinical implications of this association are discussed.

Microbiologic studies on young infants with lower respiratory tract disease.

Viral infections account for most lower respiratory tract infections in young infants (less than 60 days of age). Respiratory syncytial and parainfluenza 3 virus infections accounted for approximately three fourths of the identified virus infections. Other agents were isolated infrequently. Overall, viruses were recovered from 21% of the infants with pneumonia and 25% of the infants with bronchiolitis. Sixteen (18.0%) of 89 infants from whom paired sera were collected had diagnostic antibody rises. Four of five infants with bacteremia also had virus infections. Viral infections of the respiratory tract may play a role in the dissemination of bacterial disease.

CONTROL OF INFECTIONS IN THE NEWBORN NURSERY.

The most hopeful approach to control of infections in neonates is prevention. This should begin with recognition and therapy of infections in pregnant women. Signs of infection in young infants are subtle; early recognition requires close observation, a high index of suspicion, and use of laboratory aids such as blood cultures, cerebrospinal fluid examinations, and sensitivity studies. Besides antimicrobial therapy, supportive measures are necessary. Bactericidal agents are better than bacteriostatic ones. The drugs selected should be effective against the common pathogens if the invading microorganism is unknown. Their potential beneficial effect must outweigh their potential toxicity.

Jaundice associated with severe bacterial infection in young infants

The study is based on observations made on 24 young infants who developed jaundice in the course of a proved bacterial infection. Enteric bacilli, E. coli in particular, were the most frequently encountered etiological agents. Urinary infection occurred commonly. The sudden onset of jaundice and an elevated white blood count should make one suspicious of an infection. Bacterial cultures will establish the diagnosis. Treatment with an appropriate antibiotic results in rapid improvement of the jaundice. The theory is advanced that a hemolytic process leading to anemia and a retention type of jaundice is present initially. This is followed by toxic liver damage resulting in a regurgitation type of jaundice in most of these patients.

Staphylococcal infections in young infants; report of an outbreak in a hospital nursery.

Outbreaks of pyogenic infection in newborn infants caused by penicillin-resistant strains of Staphylococcus are becoming a major problem. The purpose of this paper is to report such an outbreak which occurred in the newborn nursery at Freedmen's Hospital during the spring of 1957. Nursery Facilities and Routines The newborn nursery is designed to accommodate 10 premature and 35 full-term infants but is frequently filled beyond capacity. The turnover is rapid, the majority of full-term infants being discharged at the age of 3 days. The number of deliveries is approximately 250 per month. About 10% of all deliveries result in premature births. There are two wards for obstetrical patients. On one of these a modified rooming-in procedure is used. The infant remains in his bassinet at the mother's bedside during the day but is returned to the nursery at night. An individual bassinet with storage space for diapers, thermometer, etc., is

Prophylaxis of upper respiratory infections in children treated with oral penicillin

Summary 1. One hundred and forty-eight children from 8 months to 10 years of age have been given 50,000 units of oral penicillin as buffered tablets one-half to one hour before breakfast and supper for twelve months, with a control group of 110 children receiving no medication. 2. The control group experienced no reduction in the average number of upper respiratory infections or the average number of febrile days in the twelve months of observation, as compared with the previous twelve months. 3. The group given penicillin prophylaxis experienced a reduction in the average number of upper respiratory infections from 5.05 in the previous year of no penicillin prophylaxis to 2.3 in the year of penicillin prophylaxis (45.5 per cent) and the group experienced a reduction in the number of febrile days from 16.76 days in the previous year to 4.24 days in the year of penicillin prophylaxis (25.3 per cent). 4. No penicillin levels are reported for this study but English and late American sources are quoted to show that such dosage would, in children of these ages and weights, produce levels definitely bactericidal. 5. The literature is reviewed to show the very controversial nature of the widely held belief that this prophylactic procedure would do harm by the production in vivo of penicillin-insensitive organisms; no such cases occurred in the 148 now reported and the 100 previously reported. 6. The suggestion is made that if these results can be corroborated in largerseries over a longer period of time, a relatively inexpensive and harmless prophylaxis of upper respiratory infections in young infants and children will be possible.