Vertical Transmission Of Infection Research Articles

Вирусный гепатит С у беременных и новорожденных

This review outlines the global incidence of hepatitis C among pregnant women. It describes the association between hepatitis C incidence and the quality of screening for hepatitis C. It also discusses the effect of hepatitis C on pregnancy and vice versa. There is a description of possible pregnancy complications related to hepatitis C, as well as the risk of vertical virus transmission to the fetus. We provide a management strategy for pregnant women infected with hepatitis C. We demonstrated that operative delivery does not reduce the risk of vertical transmission of hepatitis C. Key words: pregnancy, vertical transmission of infections, hepatitis C, newborn, complications, fetus

An Uncommon Cause for Respiratory Failure in a Preterm Neonate.

An Uncommon Cause for Respiratory Failure in a Preterm Neonate.

Evaluation of changes in Caenorhabditis elegans immune response during bacterial infection: a single nematode approach

Routinely, studies were performed using age-synchronized group of Caenorhabditis elegans as host which suggested a collective response by the host system. Here, we report the modulation of immune response in a single nematode against Staphylococcus aureus and Proteus mirabilis. Initially, the survival of wild-type N2 was tested and was found that S. aureus killed single nematode at 42 h while P. mirabilis failed to provoke infection but colonized the nematode's intestine. With this milieu, the pathogenicity of the bacteria was assessed by Fourier Transform Infra-Red (FTIR) spectroscopy and Cyclic Voltammetry (CV) and was found that S. aureus in the presence of host elicited its virulence while P. mirabilis and Escherichia coli OP50 did not show any alteration. Vertical transmission of infection was also deduced by colony forming unit assay using Cyanine dyes. The MALDI-TOF/TOF analysis was also performed to identify the proteome changes in the single nematode that showcased different proteins related to various immune pathways. This study suggested the importance of understanding the infection pathology and traits of individual nematode which could help our understanding on otherwise the disordered processes during host and microbe interactions.

Coronavirus Disease 2019 in Neonates - What Is Known and What Needs to Be Known.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first broke out in Wuhan, China, and subsequently spread worldwide affecting all ages including newborns. The cases of coronavirus disease 2019 (COVID-19) are very less in neonates and they recover well with supportive treatment. Though the vertical transmission of infection is scarcely found, to get rid of acquiring infection by horizontal transmission one should screen all pregnant women and ensure standard infection control measures and monitoring of newborns at risk of COVID-19. Neonates may present as a refusal to feed, feeding intolerance, fever, pneumonia, shortness of breath, and lethargic. Based on available evidence, antivirals like lopinavir, ritonavir, remdesivir specific medication like chloroquine/hydroxychloroquine, azithromycin, corticosteroids, and intravenous gamma globulin, are not recommended, so early detection and supportive treatment is needed for an optimal outcome.

New COVID-19 coronavirus infection in the practice of a neonatologist and pediatrician

The article analyses the data published from January 2020 to April 25, 2020 in the print media or available on the official websites of peer-reviewed medical sources (pre print), international and national medical professional communities, and state regulatory authorities dedicated to the epidemiological and clinical laboratory features of the new coronavirus infection in newborns, infants and older children. The authors have concluded that currently there are no convincing data on vertical transmission of infection. At the same time, they have found that there is a risk of horizontal infection of a newborn child; therefore, there is the need for strict adherence to the recommended algorithms for monitoring children in the neonatal period born by the women with positive or presumably positive COVID-19 (Coronavirus disease 2019) status. The authors note that due to the limited quantity of observation cases, all existing recommendations are temporary and may be revised. The newborns from mothers with COVID-19 demonstrate the variability of clinical picture from asymptomatic course to severe respiratory failure. In the post-neonatal period children have asymptomatic or mild course of a new coronavirus infection. The authors note that some children with an asymptomatic course of the disease have pneumonia detectable during X-ray examination. Children with the manifest forms of COVID-19 do not have specific clinical symptoms; both children and adults have fever, cough and other catarrhal symptoms; tachypia, tachycardia and gastrointestinal symptoms are much less common. It has been found that children with COVID-19, unlike adults, are unlikely to develop severe pneumonia, as well as conditions requiring intensive care and mechanical ventilation. Changes in laboratory parameters in children also do not have a consistent pattern and they are less pronounced than in adults. The epidemiological data indicate that children are one of the main sources of the ongoing spread of infection in the human population. The authors present the first-ever data on the cases of 45 infants born from the mothers with positive COVID-19 status in Moscow.

Failure of preventive measures leading to mother-to-child hiv transmission. Case report.

Despite significant advances in antiretroviral treatment (ARV) and HIV infection prevention, about 400 children worldwide are still diagnosed daily with HIV infection, most cases due to perinatal transmission. It is estimated that the knowledge and rigorous application of prophylactic measures to reduce the vertical transmission of infection would significantly reduce this risk to less than 1%. We report the case of a 5 months old infant coming from a pregnancy with HIV risk and multiple risk factors for transmission of the vertical infection, who did not receive postnatal testing and treatment. The diagnosis was established during infancy, falling into the AIDS stage by cytomegalovirus (CMV) disease with retinal sequelae occlusion. ARV treatment was initiated late, but from the moment of diagnosis, requiring further changes due to drug interactions, lack of availability and resistance to TARV. Although the patient’s progression was marked by severe comorbidities: sequelae of CMV disease, mixed HIV and CMV encephalopathy, pulmonary tuberculosis, repetitive respiratory and digestive opportunistic infections, the evolution of immunological parameters was slowly favorable under treatment. Proper implementation of prophylactic measures in the newborn and the pregnant woman could have significantly reduced the risk of HIV transmission to the patient, with a high probability that she would not have been infected. The case reported reflects the failure of strategies to prevent HIV / AIDS infection in pregnant women and newborns; conclusions must be drawn to avoid similar situations.

Cellular immunopathogenesis in primary Toxoplasma gondii infection during pregnancy.

Congenital toxoplasmosis is caused by the vertical transmission of infection from mother to foetus through the placenta when a pregnant woman is infected with Toxoplasma gondii (T.gondii). Congenital infection can have serious consequences, such as intrauterine abortion, foetal death and severe neurological, ocular or other organ damage in the foetus. In this review, we focus on recent publications investigating vertical transmission of T.gondii infection, cellular immunopathogenesis and protective immunity in primary toxoplasmosis during pregnancy.

Effects of Birth Spacing on Maternal, Perinatal, Infant, and Child Health: A Systematic Review of Causal Mechanisms

This systematic review of 58 observational studies identified hypothetical causal mechanisms explaining the effects of short and long intervals between pregnancies on maternal, perinatal, infant, and child health, and critically examined the scientific evidence for each causal mechanism hypothesized. The following hypothetical causal mechanisms for explaining the association between short intervals and adverse outcomes were identified: maternal nutritional depletion, folate depletion, cervical insufficiency, vertical transmission of infections, suboptimal lactation related to breastfeeding-pregnancy overlap, sibling competition, transmission of infectious diseases among siblings, incomplete healing of uterine scar from previous cesarean delivery, and abnormal remodeling of endometrial blood vessels. Women's physiological regression is the only hypothetical causal mechanism that has been proposed to explain the association between long intervals and adverse outcomes. We found growing evidence supporting most of these hypotheses.

Importance of maternal and cord blood viremia in pregnant women with chronic hepatitis B virus infection

Background/aim The spontaneous preterm birth (SPB) rates in a group of HBeAg-negative chronic HBV infected pregnant women without several known risk factors for preterm delivery as well as the mother to infant HBV transmission rates was evaluated. Moreover the role of maternal data during perinatal period as well as the role of HBsAg and/or HBV-DNA presence in cord blood in respect to preterm labour and vertical transmission of the infection was examined. Methods 138 consecutive chronic HBV infected pregnant women were haematologically, serologically and virologically evaluated during the perinatal period. 102 women were finally evaluated and fifteen of them (14.7%) exhibited SPB. Overall, 44 infants who had completed the proposed vaccination schedule were evaluated at month 12 of their life. Results A significant association between SPB and HBV-DNA presence in cord blood was observed ( p = 0.007). HBV-DNA positivity in cord blood was significantly associated with maternal HBV-DNA levels ( p = 0.002). The relative risk of HBV-DNA presence in cord blood was 6.43 times higher among women with serum HBV-DNA ≥ 10.000 copies/ml and lymphocyte count < 1500 compared to those with all the other combinations of both parameters ( p = 0.001). All infants evaluated at month 12 were HBsAg-negative and exhibited undetectable HBV-DNA levels. Conclusion The presence of HBV-DNA in cord blood is significantly associated with SPB in chronic HBV infected pregnant women. Maternal or cord blood viremia does not pose an additional risk factor for vertical transmission of HBV infection, in passive–active immunoprotected infants from HBeAg-negative chronic HBV infected mothers.

Managing Genital Herpes Infections in Pregnancy

Genital herpes is the leading cause of genital ulcer disease worldwide and it is one of the most common sexually transmitted infections. Genital herpes simplex virus infection during pregnancy poses significant risks, predominantly vertical transmission of infection with resulting neonatal disease. While uncommon, neonatal infection has a high mortality rate and significant long-term morbidity. This article will examine the current recommendations for diagnosis using serologic and viral detection techniques. Treatment options for initial and recurrent genital herpes infection in pregnancy are reviewed. The use of prophylactic antivirals and cesarean delivery are discussed. The article concludes with a look to the future, including potential changes in the management of herpes simplex virus-infected pregnant women.

Electron microscopy of mitotic cells in a measles-carrier human cell line.

The occurrence and localization of measles virus nucleocapsids during mitosis of a measles-carrier human cell line (Lu106) were studied in the transmission electron microscope. During interphase, the virus nucleocapsids were present mainly in the cytoplasm and less frequently in the nucleus. Nucleocapsids were also observed at the different stages of mitosis, always in the cytoplasm outside prophase and telophase nuclei and outside the mitotic apparatus at metaphase and anaphase. The presence of viral materials during mitosis and at the two daughter cell stage indicates a vertical transmission of infection through cell division. The frequency of infected cells in the cell population was generally high and sometimes relatively low inferring a fluctuation state in the virus/cell equilibrium.

Neospora abortions in dairy cattle: diagnosis, mode of transmission and control

Aim: To determine the contribution of Neospora caninum to abortions on a dairy farm in NSW (Australia), determine the mode of transmission and develop and trial a control option for infection. Methods: Two whole herd bleeds were conducted 12 months apart and the association between serological status and abortion events were calculated for a number of bovine abortifacients. Family trees were constructed for N. caninum seropositive cattle in the herd. Some N. caninum seropositive cows were culled from the herd and no female offspring was retained from seropositive cows. Results: At the first whole-herd bleed in December 2002 a seroprevalence of 10.2% for N. caninum infection was detected. Cows with N. caninum infection were 13 times more likely to abort than uninfected ones. Seventy-five percent of seropositive animals in the herd were related, suggesting a high degree of congenital infection/transmission. Only 15% of infections were likely to be postnatally acquired. Selective culling of seropositive cows and not breeding from them reduced the number of seropositive animals. Only one newly sero-converted cow was detected at the second whole-herd bleed 12 months later. Conclusions: Seroepidemiological approaches were able to establish a high degree of association between N. caninum infection and low-level abortion in the dairy herd. Vertical transmission of infection was the predominant mode of infection and hence control efforts aimed at selectively culling seropositive animals from the herd were highly successful in reducing the level of infection.

A PILOT STUDY OF CHLAMYDIA TRACHOMATIS PNEUMONIA IN INFANTS

Chlamydia trachomatis is currently recognized as one of the most common sexually transmitted pathogen and a major cause of perinatally acquired infection. Vertical transmission of infection from mother to the infant may result in the development of conjunctivitis and pneumonia. The study was conducted with the aim of determining the prevalence of C. trachomatis pneumonia and to identify its clinical manifestations. Nasopharyngeal aspirates were collected from 50 infants (4-24 weeks of age) with pneumonia. C. trachomatis was detected in nasopharyngeal aspirates by direct fluorescent antibody (DFA) staining. Using DFA, C. trachomatis was found in 12.5% of infants. C. trachomatis pneumonia was associated with the age group of 4-12 weeks, cough of more than 7 days duration, presence of conjunctivitis, milder grade of pneumonia and absence of fever. The study showed a high prevalence of C. trachomatis pneumonia in infants.

State of the art prenatal care from the Swiss viewpoint

Prenatal care has significantly reduced perinatal and maternal mortality. Screening for maternal disease allows us to reduce or to prevent an unfavourable fetal or obstetrical outcome. Prenatal care should start with a first preconceptional visit. Folic acid intake is recommended for all reproductive-age women who are capable of becoming pregnant. The fetal nuchal translucency measurement has revolutionized prenatal care as a non-invasive, effective screening for chromosomal abnormalities and other diseases of the fetus. Vertical transmission of infections has to be prevented if possible. As an example caesarean section in combination with antiretroviral therapy reduces the transmission of HIV significantly. Screening for sexually transmitted diseases (STD) remains important as at present the incidence of STD is increasing again. In this short review on prenatal care as it is done in Switzerland, we try to enlighten its most important aspects. For the patients and your own benefit as a physician it is important to follow guidelines, although of course each patient has to be treated individually.

The implications of HIV for the anaesthetist and the intensivist.

The acquired immune deficiency syndrome has reached pandemic proportions. Anaesthetists should be aware of the implications of dealing with increasing numbers of both diagnosed and undiagnosed, symptomatic and asymptomatic, human immunodeficiency virus-infected patients in the fields of intensive therapy, operating theatre anaesthesia, obstetrics and pain management. With recent advances, important insights have been gained into the pathogenesis of human immunodeficiency virus. Molecular techniques allow quantification of viral burden, and together with CD4 T-lymphocyte count, prognosis and response to therapy can be evaluated. New drugs and therapeutic regimens have improved prognosis for those who are infected with the virus and vertical transmission of infection from mother to infant can be minimised. Should accidental occupational exposure to the virus occur, a prophylactic regimen of antiretroviral drugs can be administered in an attempt to prevent subsequent human immunodeficiency virus infection.

Association between the biological characteristics of HIV-1, vertical transmission of infection and clinical progression of pediatric disease

The design of effective prophylactic measures to prevent the vertical transmission of HIV-1 and of therapies to alter the natural progression of pediatric HIV disease requires a thorough understanding of basic pathogenetic principles. Maternal viral load, the biological behavior of HIV, such as replicative capacity in different types of cells, monocyte/macrophage tropism, and the capacity of the infant's cells to support infection have all been assessed for their contribution to the risk of mother-to-child transmission. Similarly, the effects of viral load and phenotype (e.g. replicative capacity, cell tropism, syncytium-inducing capacity and the use of chemokine co-receptors) have all been investigated as parameters associated with variations in the expression of clinical disease in children. Some of the extant data are conflicting, but general principles regarding pathogenesis are beginning to emerge.

Maternal HIV-1 viral load and vertical transmission of infection: the Ariel Project for the prevention of HIV transmission from mother to infant.

Most HIV-1 infections of children result from mother-to-infant transmission, which may occur perinatally or postnatally, as a consequence of breast feeding. In this study, the influence of maternal viral load on transmission of infection to infants from non-breast-feeding mothers was examined using samples of plasma and peripheral blood mononuclear cells (PBMCs) collected at several time points during pregnancy and the 6-month period after delivery. These samples were analyzed by several quantitative methods, including virus cultures of PBMCs and polymerase chain reaction (PCR) assays for HIV-1 RNA in plasma and DNA in PBMCs. The risk of transmission increased slightly with a higher viral load, but transmission and nontransmission occurred over the entire range of values for each assay. No threshold value of virus load was identified which discriminated between transmitters and nontransmitters. We also noted a significant rise in viral load and a decline in CD4+ lymphocytes in the six months after delivery. These findings suggest that a high maternal viral load is insufficient to fully explain vertical transmission of HIV-1. Additional studies are needed to examine the post-partum increase in viremia.

Risks of transmitting scrapie and bovine spongiform encephalopathy by semen and embryos.

This paper reviews current knowledge on transmission of scrapie and bovine spongiform encephalopathy (BSE) by semen and embryos. In sheep, in particular, it is difficult to distinguish between the genetic transmission of susceptibility to scrapie and vertical transmission of the infection. Nevertheless, there is evidence that vertical transmission of infection does occur, probably across the placenta, but none to suggest a significant scrapie risk from semen. Two teams have studied scrapie transmission from experimentally infected sheep using embryo transfer. Whereas one team found no evidence for transmission, the results from the other team suggest that embryos, even after washing, might carry the disease into the offspring. In regard to goats, although genetic differences in susceptibility exist, they are much less obvious than in sheep. There is no evidence for vertical transmission or for transmission through semen and embryos. With regard to BSE, although it appears that genetic differences in susceptibility are absent or unimportant, some recent work does suggest that the disease may be passed from cow to calf. The route of transmission and stage or stages when this takes place are unclear, however. In conclusion, despite growing evidence to indicate that scrapie and BSE are unlikely to be transmitted through semen and embryos, more research is needed to confirm this. Furthermore, until all possibility of risk is ruled out, risk reduction methods must be considered, especially when semen and embryos are being imported into countries where the diseases do not exist.

Pancreatitis in pediatric human immunodeficiency virus infection

Because pancreatitis has been reported frequently in adults with human immunodeficiency virus infection, we sought to determine the incidence of pancreatitis in children with acquired immunodeficiency syndrome by reviewing all records of children with AIDS, their serum amylase and lipase levels, and the factors associated with pancreatitis through a case-control analysis. During a 6-year period pancreatitis developed in 9 (17%) of 53 pediatric patients with AIDS. Six children had vertical transmission of infection and three patients had acquired HIV infection through contaminated blood products. Pancreatitis developed at a median age of 5.2 years (range 1.2 to 20 years). All patients had vomiting and abdominal pain. When the patients were first seen, lipase values were elevated more than amylase values (p = 0.028). Amylase and lipase levels declined at comparable rates. In the case-control analysis, pentamidine isethionate was significantly associated with pancreatitis (p = 0.02); the risk was greater in patients who received pentamidine isethionate and had absolute CD4 T-lymphocyte counts less than 100 cells/mm3 (p = 0.001). Infections associated with the onset of pancreatitis included cytomegalovirus (4), Cryptosporidium (1), Pneumocystis carinii pneumonia (3), and Mycobacterium avium intracellulare (1). Coinfection with cytomegalovirus was associated with a protracted course in four children. Ultrasonographic examination demonstrated biliary ductal dilatation 6 months after the onset of pancreatitis in one child. Seven children have died at a mean of 8 months after the initial onset of pancreatitis; the one living child has survived 5 months from the onset of pancreatitis. We conclude that pancreatitis is common in pediatric patients with AIDS and may be related to pentamidine isethionate exposure, especially when absolute CD4 T-lymphocyte counts are less than 100 cells/mm3. Serum amylase levels do not always accurately predict the onset of pancreatitis; serum lipase levels should be measured in children with symptoms. The onset of pancreatitis in an HIV-infected child is a poor prognostic indicator.

Cranial irradiation in the management of extreme leukemic leukocytosis complicating childhood acute lymphocytic leukemia

probably occurring within 72 hours of exposure? In any event a cluster of cases occurring over three weeks is unlikely to be caused by a point source of contamination; a continuing common source or person-to-person transmission is more likely. Al though poultry are frequently contaminated by Campylobacter, '~ consumption of poultry was not a factor in either outbreak. In both outbreaks, illness spread beyond the immediate household. However, neither food nor water from these homes was transported to the other households. In both clusters the only contacts for the people who were ill late in the outbreaks were the symptomatic, fecally incontinent young children. Other enteric infections, including shigellosis, 7 giardiasis? and amoebiasis, are known to be transmitted by the fecal-oral route. Symptomatic infected infants and children are important vehicles for transmitting these pathogens within households and in communities. Our experience suggests that the same may be true for Campylobacter. C. f e tu s ssp. je juni is a common enteric pathogen for young children '~ and feces of infants may be an important vehicle for transmitting infection to family members and playmates. Vertical transmission of infection from a mother to her neonate has recently been reported.' The infective dose of C. fe tus ssp. j e jun i is unknown; as with other enteric pathogens, this may be a determinant of the frequency with which specific modes of transmission are implicated. We thank Dr. Allan R. Lareau for bringing these cases to our attention and to Dr. Kenneth VanderVelde for clinical information.