Relevance of enteroviruses in neonatal meningitis.

INTRODUCTION: Enterovirus (EV) infections are the most frequent infections in the neonatal period and in many cases lead to hospital admission of the newborn (NB). The aim of this study was to determine the incidence of EV in the etiology of neonatal meningitis and to define the clinical characteristics of newborns with EV meningitis. MATERIAL AND METHOD: Retrospective observational cohort study. Including 91 NBs with meningitis and gestational age greater than 34 weeks gestational age (GA) attended in our center over a period of 16 years. RESULTS: The percentage of NBs with EV meningitis was higher than that of NBs with bacterial meningitis (BM) and accounted for 78% (n=71). Half of the NBs with EV infection had a history of epidemic environment among their caregivers. Fever was present in 96% of cases as a clinical sign and, in general, sensory disturbances represented the main neurological alterations. Antibiotics (ATB) were given to 71.4% of patients with EV infection. Detection of EV in CSF samples showed a high sensitivity for the diagnosis of EV meningitis. The most frequently implicated EV types were echovirus 11, coxsackievirus B5, echovirus 18, 25 and 7. CONCLUSIONS: The results of this series show that enterovirus infection is a common cause of neonatal meningitis. These data underline the importance of rapid EV testing of infants with suspected meningitis. This allows early diagnosis and reduces antibiotic treatment, hospitalization time and related costs.

[Follow-up recommendations for the late preterm infant]. / Recomendaciones de seguimiento del prematuro tardío.

The population of late preterm infants (PT), those born between 34+0 and 36+6 weeks of gestation, accounts for 70-74% of all premature infants, and is not specifically included in most of the follow-up protocols for preterm infants. For many years, PTs have been handled as if they were term newborns, which has led to a limited knowledge of their outcome in the medium and long term. Their neonatal morbidity is associated with a higher incidence of postnatal complications, with an increased rate of hospital re-admissions due to malnutrition, hyperbilirubinaemia, and respiratory problems, when compared to term infants. Cerebral immaturity may be the main cause of the deficits observed in the long-term neurodevelopment of this population, making them more vulnerable. Several issues have been described, such as delays or disabilities in the pre-school stage, cerebral palsy, mental retardation, intellectual disability, schizophrenia, and psychological development of behavioural and emotional disorders. The SEN34-36 Group of the Spanish Society of Neonatology, in collaboration with the Spanish Association of Primary Care Paediatrics, have developed these follow-up recommendations with the main objective of reducing the impact of prematurity on PT development. The secondary objectives of the document are to make neonatologists and paediatricians aware of the risks of sequelae of PTs, to determine and unify the evaluations and / or interventions that should be carried out, to offer clinical follow-up tools for the early detection of developmental delays, and to coordinate the care by all the professionals involved.

[Follow-up protocol for newborns of birthweight less than 1500 g or less than 32 weeks gestation]. / Protocolo de seguimiento para el recién nacido menor de 1.500 g o menor de 32 semanas de edad gestación.

The mortality of children with a birthweight of less than 1500g or with a gestational age of less than 32 weeks (<1500<32) has decreased significantly in the last 20 years or so. Given the higher risk of disability in these children, follow-up after hospital discharge is considered essential. In this document, the Follow-Up Group of the Spanish Society of Neonatology, in collaboration with the Spanish Society of Paediatric Primary Care, propose a follow-up protocol specific for the<1500<32, which has as its aim to standardise the activities and evaluations according to good practice criteria.