To describe missed opportunities in the prevention of congenital syphilis (CS) and to analyze antenatal factors associated with clinical and/or laboratory manifestations at birth in a cohort of CS neonates in Brazil. This cohort study included 240 neonates evaluated for CS between 2016 and 2021. Neonates were categorized as (1) Infected-clinical, laboratory or imaging findings compatible with CS or a Venereal Disease Research Laboratory titer ≥4-fold the maternal titer; (2) Reported-reactive Venereal Disease Research Laboratory (maternal and neonate samples) without clinical/laboratory abnormalities and maternal inadequate or absent treatment; and (3) Exposed-adequate maternal treatment and no signs of CS at birth. Maternal and perinatal variables were collected and compared across groups. Among the 240 neonates, 55% were male and 69% non-White. Although 94% of mothers received antenatal care (mean 7.3 visits), only 72% were treated for syphilis, and several received inadequate or delayed treatment. Thirty-three neonates (14%) met criteria for CS infection; 64 (26%) were reported and 143 (60%) were classified as exposed. Infected neonates presented with neurosyphilis (18%), bone abnormalities (6%) or nonspecific signs, including low birth weight, prematurity and hepatomegaly. Multivariate analysis identified maternal recreational drug use (odds ratio = 5.75; 95% confidence interval: 1.20-27.51) and lack of partner treatment during pregnancy (odds ratio = 3.48; 95% confidence interval: 1.08-11.23) as independent risk factors for neonatal classifications as CS infected. A significant proportion of CS cases occurred due to inadequate maternal management (64/97, 67%). Interventions must prioritize comprehensive maternal-partner management and consider behavioral risk factors in the CS cascade of care.

Background Neonatal infections are a leading cause of mortality in dogs, with up to 30% of puppies dying within the first 3 weeks of life. During this critical period of immune development, protection is highly dependent on maternal antibodies (MatAbs) transferred across the placenta and via colostrum. Despite the critical importance of this transfer, limited information is available regarding the biological or clinical factors that determine its magnitude, whether specific antibodies are preferentially transferred, or how these processes vary across a broad population of dogs. Methods To quantify and explore the determinants of MatAb transfer in dogs, we analyzed matched maternal serum, cord blood, and colostrum samples collected from 44 client-owned dams undergoing cesarean section at a university veterinary hospital. Total immunoglobulin G (IgG) and virus-specific antibodies against canine parvovirus (CPV) and canine distemper virus (CDV) were analyzed. We also evaluated the influence of maternal factors, including age, breed, body weight, parity, and litter size, on MatAb transfer efficiency. Results Across this diverse population, we observed limited transplacental transfer of MatAbs (4.5%–6% of the maternal titer), consistent with previous studies and as expected given the endotheliochorial placenta of dogs. In contrast, virus-specific IgG was highly enriched in colostrum, with 10.7-fold (CPV) and 8.1-fold (CDV) increases relative to serum. Transfer efficiency was significantly greater for virus-specific antibodies than for total IgG (3.2-fold), suggesting selective enrichment of antiviral antibodies during colostrogenesis. Maternal serum antibody titer emerged as the primary factor influencing antibody transfer efficiency. Conclusions These findings provide the most comprehensive quantification to date of MatAb transfer routes in dogs, revealing preferential transfer of virus-specific IgG to colostrum and highlighting the crucial role of colostrum intake in neonatal immunity. This work establishes a foundation for identifying antibody characteristics that influence MatAb transfer efficiency and reinforces the importance of ensuring that dams have adequate titers of virus-specific IgG prior to breeding.

Abstract Background Antimicrobial resistance is an increasing cause of neonatal infection-related mortality. Colonization with carbapenem-resistant organisms (CRO) may precede and increase the risk for subsequent infection in neonates. In this study, we evaluated associations between CRO colonization and infectious outcomes among neonates admitted to a neonatal intensive care unit (NICU). Methods From July 2023 to February 2024, a prospective cohort study was conducted among neonates admitted to a tertiary hospital NICU. Neonates were assessed for CRO colonization using rectal swabs collected within 24 hours of admission, on days 3 and 7, and weekly until discharge, transfer, or death. Swabs were plated on selective agar followed by VITEK-2 identification and susceptibility testing. VITEK-2 was also used for blood and tracheal aspirate culture isolates in suspected sepsis cases. Risk ratios (RR) and other analyses were performed using Stata v15. Results From July 2023 to February 2024, 423 neonates were enrolled (median age 4 days; IQR 2–8), 62% male. At enrollment, 51% (214) were colonized with CROs. Of those who were not colonized at enrollment, 80% (167/209) acquired colonization during their hospital stay (Figure 1). Among CRO-colonized neonates, 71% had Klebsiella pneumoniae (Kpn), 36% Pseudomonas aeruginosa, 36% Acinetobacter baumannii, and 31% Escherichia coli (Figure 2). Clinically suspected infections occurred in 113 (27%) neonates. Of 33 positive bacterial cultures, 10 (30%) were CROs, including Kpn (4), E. meningoseptica (2), A. baumannii (1), A. lwoffii (1), E. coli (1), and B. cepacia (1). Three clinical isolates had antibiotic susceptibility patterns matching with colonized strains; all were CR-Kpn. CRO colonization at any time point was associated with confirmed bacterial infection (RR 1.11, 95% CI 1.05–1.17). Conclusion CRO colonization was common among NICU patients and increased throughout the hospital stay. These findings highlight the urgent need of targeted prevention strategies to reduce CRO transmission and infection risk among this vulnerable population. Disclosures All Authors: No reported disclosures

PurposeTo examine the accuracy of the diagnoses of early-onset neonatal infection in the Danish National Patient Register.Patients and MethodsAll Danish neonates born after 35 weeks of gestation with an ICD10 diagnosis of sepsis or meningitis within the first week of life between 2010 and 2018 were identified. To examine the validity of the diagnoses, medical records were reviewed for 500 neonates diagnosed with sepsis and all 63 neonates diagnosed with meningitis. Proven infection was defined by bacterial pathogens identified from blood or cerebrospinal fluid. Probable sepsis was defined as at least 5 days of antibiotic treatment, two clinical signs of infection, and one abnormal blood biomarker. Probable meningitis was defined as at least 14 days of antibiotics, neurological affection, and cerebrospinal fluid analysis consistent with meningitis. Positive predictive values (PPVs) with 95% CI were estimated using the proven definition of infection as well as the criteria for either proven or probable infection.ResultsThe PPV for sepsis diagnoses using the proven definition was 0.04 (0.02, 0.06), while the PPV using both the proven and probable definition was 0.52 (0.45, 0.58). Sepsis diagnoses with a specified pathogen showed the highest PPV for proven sepsis at 0.36 (0.29, 0.43) and for proven or probable sepsis at 0.65 (0.58, 0.72). The PPV for meningitis diagnoses using the proven definition was 0.24 (0.13, 0.37), while the PPV using both the proven and probable definition was 0.38 (0.25, 0.52).ConclusionWe found a poor validity for the ICD10 diagnoses of early-onset neonatal infection in the Danish National Patient Register. This highlights that the diagnoses should be used cautiously in future research and surveillance and emphasises the need for supporting information on microbiological samples. Additionally, this highlights the importance of establishing a consensus definition of neonatal sepsis to improve diagnostic accuracy.

COVID-19 in newborns presents a multifaceted clinical spectrum, with the potential for severe outcomes. This study aimed to evaluate the clinical evolution and hospital outcomes of neonates with a molecular diagnosis of COVID-19. A case-control study was conducted in a public referral maternity hospital for high-risk pregnancies. Two controls were selected for each case, matched by sex and gestational age. Variables related to birth data, symptoms, and clinical progression were collected from medical records and analyzed statistically, with crude and adjusted relative risks calculated using Poisson regression with robust standard errors. A total of 25 neonates with confirmed SARS-CoV-2 infection were identified among 875 newborns. Compared with controls, infected neonates had a longer hospital stay (median of 19 days vs. 8 days; p < 0.001) and higher readmission rates (16% vs. 0%; p = 0.03). After adjusting for potential confounders, COVID-19 infection was associated with a 2.41-fold higher risk of neonatal death (95% CI: 1.24–4.67; p = 0.009). No evidence of vertical transmission was found. These findings suggest that neonates with COVID-19 may experience longer hospitalizations and an adjusted higher risk of mortality, emphasizing the need for vigilant surveillance and supportive care. However, given the observational design of the study, these results indicate associations rather than causal relationships. Understanding the clinical behavior of COVID-19 in this population—characterized by inherently low immunity—and recognizing its interaction with other neonatal conditions are essential for improving hospital management and outcomes.

The current status of neonatal echovirus 11 infections in Japan: A comparison to the global situation.

Detection and characterization of neonatal cytomegalovirus through nanopore sequencing using flongle flow cells: Pilot study in Philadelphia, Pennsylvania.

Culture Prescription Practices for Suspected Neonatal Bacterial Infections in Countries with Limited Resources

TREM-1: A potential prognostic marker in newborns with late-onset sepsis.

Objective: To evaluate the frequency of urinary tract infection (UTI) in neonates with prolonged jaundice. Study Design: Quasi-experimental study. Place and Duration of Study: Neonatal Unit, Ghurki Trust Teaching Hospital, Lahore Pakistan, from Apr to Oct 2022. Methodology: The study included 140 newborns having jaundice for >2 weeks. Blood and urine samples were obtained from patients upon admission and urine samples were sent for culture and urinalysis to detect the presence of pyuria, where 10,000 CFUs of a single infectious agent indicated a urinary tract infection. Additional examinations such as kidney function tests, renal ultrasonography, voiding cystourethrography, and renal scintigraphy were conducted on patients who had a positive urine culture for bacteria. Results: Out of 140 patients, 88(62.86%) were males and 52(37.14%) were females. In 26 out of 140 neonates (18.57%), UTI was present. Out of 26, 12(23.08%) were females and 14(15.91%) were males. UTI positive group had significant serum bilirubin values compared to UTI negative group (p<0.001). The microorganisms that were found in isolation were Proteus mirabilis in 4(15.38%), Klebsiella pneumonia in 6(23.08%), and Escherichia coli in 16(66.67%) patients. Conclusion: The prevalence of urinary tract infection in neonates presenting with prolonged jaundice is significant and females were noted to be affected more.

Objective: To determine the prevalence of and risk factors for congenital toxoplasmosis in neonates treated in the public health network of the eastern region of the Brazilian Amazon, northern Tocantins state. Methods: A retrospective cohort study was conducted with neonates born to mothers with gestational toxoplasmosis who received care between 2017 and 2024. The outcome under analysis was positivity for immunoglobulin M in the electrochemiluminescence assay (CLIA). We estimated the prevalence of transplacental infection and respective 95% confidence intervals (95% CI) and its association with risk factors using the odds ratio (or) with a p-value < 0.05 in infected neonates before and after 16 gestational weeks at maternal infection diagnosis. Results: A total of 1142 neonates were surveyed, in which 496 were diagnosed with congenital toxoplasmosis (IgM positive), thus obtaining a prevalence of vertical transmission of 45.4%. The main risk factors for vertical transmission were the mother’s education level equal to or less than eight years, (OR = 1.5; 95% CI 1.2;2.0) and having less than six prenatal consultations (OR = 22.8; 95% CI 3.0;172.6). Conclusions: A high prevalence of congenital toxoplasmosis was observed, with higher rates of infection in neonates born to mothers with lower levels of education.

INTRODUCTION: Active methodologies are essential to make learning more dynamic and effective. Real Lab Day, a strand of the #Adote Project, prometes this approach by offering practical activities in research laboratories, allowing undergraduate students to experience scientific work. Among the topics addressed, bacterial resistance stands out, a global problem aggravated by the indiscriminate use of antibiotics. Streptococcus aga/actiae (GBS), bacteria associated with infections in pregnant women and neonates, have shown increasing resistance to antibiotics, evidencing the need for therapeutic alternatives. Phage endolysins, proteins responsible for bacterial lysis, represent a promising approach, but still little explored in higher education. OBJECTIVES: This work proposes the development of an experimental project to demonstrate the action of a recombinant endolysin, produced by the group, as an alternative to the use of antibiotics against GBS. MATERIALS AND METHODS: to demonstrate the action of a recombinant endolysin, produced by the group, as an alternative to the use of antibiotics against GBS. DISCUSSION AND RESULTS: The protocol was designed to apply this experimental activity in the higher education course that enables the integration of concepts of bacterial resistance, virology and biochemistry, providing an interdisciplinary and applied experience. CONCLUSION: ln addition, it stimulates students1 criticai thinking, bringing scientific research closer to academic training.

Background: Parvovirus B19 (B19V; Erythroparvovirus primate 1) is now the most commonly detected virus in human endomyocardial biopsies from patients with myocarditis or dilated cardiomyopathy; however, its true causal role remains uncertain. By contrast, Protoparvovirus carnivoran 1, also known as canine parvovirus type 2 (CPV-2), is an apparent cause of myocarditis in neonatal puppies, where it replicates in cardiomyocytes, induces extensive cell death, and often leaves fibrotic scars in survivors. Conclusions: This review compares B19V and CPV-2 from basic biology to clinical expression. Divergent tropism and replication kinetics produce distinct injury patterns: predominantly endothelial and microvascular dysfunction with immune-mediated damage in adult human B19V infection versus direct, age-restricted cardiomyocyte lysis in neonatal CPV-2 infection, often followed by fibrosis. Because parvoviral DNA can persist in cardiac tissue, detection alone does not prove causality. We advocate an “evidence bundle” integrating viral load by quantitative polymerase chain reaction (qPCR), detection of viral transcripts and/or proteins when feasible, spatial co-localization with histological injury, and concordant clinical markers (cardiac troponins and advanced imaging, including cardiac magnetic resonance imaging [CMR]) to support etiologic attribution and guide management in human and veterinary cardiology.

Phlegmonous gastritis is a rare, potentially life-threatening bacterial infection affecting the gastric mucosa and submucosa. Clinical presentation is often non-specific, typically including symptoms such as fever, epigastric vomiting, or hematemesis. Due to its rarity and vague clinical features, diagnosis is frequently delayed, increasing the risk of severe complications such as septic shock and death. We describe the case of a 74-year-old previously healthy female who presented with vomiting, hematemesis, and epigastric pain. Endoscopy revealed diffuse erythema and purulent exudate throughout the stomach, raising suspicion for Phlegmonous gastritis. Although blood and gastric juice cultures were negative, gastric tissue culture identified Cronobacter species. Cronobacter species is an opportunistic pathogen primarily associated with severe infections in neonates, though it has also been reported in immunocompromised adults. The patient responded well to targeted antibiotic therapy and recovered without requiring surgery. This case highlights the diagnostic and therapeutic utility of gastric tissue culture in Phlegmonous gastritis, especially when conventional cultures fail to identify a pathogen. It also underscores the role of Cronobacter species as a rare but relevant pathogen in adult gastrointestinal infections such as Phlegmonous gastritis.

Citrobacter koseri is a Gram-negative, multidrug-resistant bacterium linked to severe infections in immunocompromised individuals and neonates. It is especially linked to sepsis and meningitis, which often lead to CNS abscesses in newborns. Most infections happen randomly, but some are passed down from parent to child. There have also been reports of hospital-acquired outbreaks in neonatal care units. Even though diagnostic and treatment methods have improved, the death rate is still high. About one in three affected babies dies, and almost half of them suffer long-term neurological damage. As antibiotic resistance becomes more common, there is a growing need to look into new ways to treat diseases, such as vaccines and new drug targets. In order to address this issue, a thorough in-silico methodology integrating subtractive proteomics and reverse vaccinology was employed to pinpoint potential therapeutic targets from the core proteome. Five multi-epitope vaccine constructs were created using B- and T-cell epitopes from prioritized proteins, based on epitope prediction. Physicochemical and docking analysis identified constructs V1 and V5 as having strong binding affinities to Toll-like receptors TLR4 and TLR2, respectively. Furthermore, MD simulations validated the structural stability of docked complexes. In-silico immune simulations revealed that the constructs might induce robust immune responses. Additionally, potential drug target proteins were subjected to druggability analysis. This study presents a promising computational framework for combating C. koseri, though experimental and animal model validations are necessary to confirm the findings of this study.

Background: Postnatal cytomegalovirus (pCMV) infection is a frequent viral condition in early infancy and is primarily acquired through maternal breastfeeding. Although usually asymptomatic in term infants, it can lead to significant morbidity in preterm neonates (gestational age < 32 weeks) and in those with very low birthweight (<1500 g), presenting with sepsis-like syndrome, pneumonia, cytopenia, hepatitis, or colitis. Severe cases may result in long-term sequelae or death. Objectives: To describe a series of cases of pCMV infection and review the current evidence on its epidemiology, clinical manifestations, outcomes, and therapeutic management, aiming to identify gaps in knowledge and propose opportunities for improving the care of preterm infants. Methods: We analyzed clinical presentations of pCMV disease in a case series of preterm infants and reported cases and reviewed the recent literature regarding diagnostic approaches, antiviral therapy, and strategies for breastmilk management. Results: Current data highlight substantial variability in clinical management and outcomes. The lack of consensus on antiviral indications and treatment duration reflects a limited understanding of the disease’s natural history. Approaches to breastmilk handling differ widely among centers and countries, further complicating the standardization of care. Conclusions: pCMV infection remains a relevant yet under-recognized condition in neonatal medicine. Improved diagnostic strategies, clearer therapeutic guidelines, and harmonized recommendations for breastmilk management are needed to optimize the care of preterm infants at risk of or affected by pCMV disease.

Congenital cytomegalovirus (CMV) is a large contributor to neurodevelopmental delay and non-genetic related sensorineural hearing loss, which can often be delayed in onset. While a majority of CMV infections are asymptomatic in healthy children and adults, CMV infection of immunocompromised hosts and in utero infection in neonates can cause more clinically significant and potentially long-term disease. Increased awareness of the significance of congenital CMV is reflected in the evolution of treatment recommendations over the past 20years. Most therapeutic studies conducted thus far have focused on the treatment and outcomes of neonates with moderate to severe congenital CMV disease, while more recent studies have explored treatment for neonates and infants with CMV-related isolated sensorineural hearing loss. This review focuses on the clinical significance and treatment of congenital CMV infection, as well as the potential role for universal newborn CMV screening.

Group B Streptococcus (GBS) is a component of the natural human microbiota, colonizing the genitourinary tract and the distal gastrointestinal tract. Due to its production of numerous virulence factors, GBS can cause infections in pregnant women, newborns, and immunocompromised individuals. In newborns, GBS infection may present as severe pneumonia, meningitis, or sepsis. Screening for maternal GBS colonization, combined with intrapartum antibiotic prophylaxis for colonized women, is currently regarded as the most effective strategy for preventing neonatal GBS infections. However, growing concerns regarding antibiotic resistance and the negative impact of antibiotics on the neonatal microbiome have intensified the search for alternative approaches. These include the development of a vaccine and methods to reduce vaginal colonization in pregnant women.

Objective:To describe the clinical and laboratory characteristics of Gram-negative neonatal infections and to identify risk factors associated with multidrug-resistant (MDR) Gram-negative infections at the Pediatric Center, Bach Mai Hospital, during 2023–2025. Methods:A cross-sectional study combined with a case–control design was conducted among neonates (<28 days old) diagnosed with neonatal sepsis. The case group included 60 infants with culture-confirmed MDR Gram-negative infections, and the control group consisted of 180 infants with negative cultures. Clinical manifestations, laboratory findings, and potential risk factors were collected and statistically analyzed. Results:Among 60 cases of Gram-negative neonatal infections, late-onset sepsis accounted for 78.9%, while early-onset sepsis accounted for 21.1%. Klebsiella pneumoniae was the most common pathogen (42.3%). The predominant clinical features were respiratory distress (83.3%), tachypnea ≥60 breaths/min (75%), chest retraction (73.3%), SpO₂ <90% (56.7%), poor feeding (56.7%), and jaundice (35%). Laboratory abnormalities included leukocytosis (43.3%), thrombocytopenia (40%), hypoalbuminemia (66.7%), elevated CRP (78.3%), and coagulopathy(70%).Significant risk factors for MDR Gram-negative infection (p <0.05) included age at admission ≥7 days, late-onset sepsis, bag-mask ventilation or re-intubation, blood transfusion, parenteral nutrition, umbilical or central line catheterization, invasive mechanical ventilation ≥7 days, use of vasopressors, and exposure to ≥2 antibiotics or antibiotic regimen changes during treatment. Conclusion:Gram-negative neonatal infections, particularly those caused by Klebsiella pneumoniae, are common and mainly associated with late-onset sepsis. Respiratory symptoms predominate, often accompanied by hematologic, biochemical, and coagulation abnormalities. Early identification and close monitoring of high-risk neonates, adherence to aseptic techniques, effective infection control, and rational antibiotic use are essential to improve outcomes and reduce mortality.

Introduction: In 2022, about 15% of infants treated in the NICU of RSUD Undata experienced respiratory distress neonatal (RDN), mostly related to preterm birth and neonatal infection. Objective: To identify factors influencing RDN in the NICU of RSUD Undata. Methods: A quantitative cross-sectional study conducted from August to October 2025 involving 43 mothers selected through purposive sampling. Univariate analysis described variable distribution, while logistic regression identified factors associated with RDN. Results and Discussion: Logistic regression showed a Chi-Square of 42.396 (p = 0.000), indicating that low birth weight (LBW), neonatal infection, gestational diabetes, and maternal age simultaneously affected RDN. Partially, LBW (p = 0.016), neonatal infection (p = 0.028), and gestational diabetes (p = 0.041) significantly influenced RDN, while maternal age (p = 0.417) did not. Conclusion: LBW, neonatal infection, and gestational diabetes significantly contributed to RDN, with LBW as the most dominant factor.