RESUMEN
BACKGROUND: To determine whether the secretor gene fucosyltransferase (FUT)2 polymorphism G428A is predictive for adverse outcomes in a large cohort of very-low-birth weight (VLBW) infants. METHODS: We prospectively enrolled 2,406 VLBW infants from the population-based multicenter cohort of the German Neonatal network cohort (2009-2011). The secretor genotype (rs601338) was assessed from DNA samples extracted from buccal swabs. Primary study outcomes were clinical sepsis, blood-culture confirmed sepsis, intracerebral hemorrhage (ICH), necrotizing enterocolitis (NEC) or focal intestinal perforation requiring surgery, and death. RESULTS: Based on the assumption of a recessive genetic model, AA individuals had a higher incidence of ICH (AA: 19.0% vs. GG/AG: 14.9%, P = 0.04) which was not significant in the additive genetic model (multivariable logistic regression analysis; allele carriers: 365 cases, 1,685 controls; OR: 1.2; 95% CI: 0.99-1.4; P = 0.06). Other outcomes were not influenced by FUT2 genotype in either genetic model. CONCLUSION: This large-scale multicenter study did not confirm previously reported associations between FUT2 genotype and adverse outcomes in preterm infants.
Asunto(s)
Fucosiltransferasas/genética , Recién Nacido de muy Bajo Peso , Perforación Intestinal/genética , Polimorfismo Genético , Hemorragia Cerebral/genética , Enterocolitis Necrotizante/genética , Femenino , Genes Recesivos , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Enfermedades del Prematuro , Intestinos/anomalías , Masculino , Estudios Prospectivos , Sepsis/genética , Galactósido 2-alfa-L-FucosiltransferasaAsunto(s)
Fiebre/etiología , Herpesvirus Humano 4/aislamiento & purificación , Leishmaniasis Visceral/diagnóstico , Pancitopenia/etiología , Anfotericina B/administración & dosificación , Anfotericina B/uso terapéutico , Antiprotozoarios/administración & dosificación , Antiprotozoarios/uso terapéutico , Preescolar , Europa (Continente) , Humanos , Leishmaniasis Visceral/tratamiento farmacológico , ViajeRESUMEN
Infections caused by Panton-Valentine leukocidin-positive Staphylococcus aureus (PVL-SA) mostly present as recurrent skin abscesses and furunculosis. However, life-threatening infections (eg, necrotizing pneumonia, necrotizing fasciitis, and osteomyelitis) caused by PVL-SA have also been reported.We assessed the clinical phenotype, frequency, clinical implications (surgery, length of treatment in hospitals/intensive care units, and antibiotic treatments), and potential preventability of severe PVL-SA infections in children.Total, 75 children treated for PVL-SA infections in our in- and outpatient units from 2012 to 2017 were included in this retrospective study.Ten out of 75 children contracted severe infections (PVL-methicillin resistant S aureus nâ=â4) including necrotizing pneumonia (nâ=â4), necrotizing fasciitis (nâ=â2), pyomyositis (nâ=â2; including 1 patient who also had pneumonia), mastoiditis with cerebellitis (nâ=â1), preorbital cellulitis (nâ=â1), and recurrent deep furunculosis in an immunosuppressed patient (nâ=â1). Specific complications of PVL-SA infections were venous thrombosis (nâ=â2), sepsis (nâ=â5), respiratory failure (nâ=â5), and acute respiratory distress syndrome (nâ=â3). The median duration of hospital stay was 14 days (range 5-52 days). In 6 out of 10 patients a history suggestive for PVL-SA colonization in the patient or close family members before hospital admission was identified.PVL-SA causes severe to life-threatening infections requiring lengthy treatments in hospital in a substantial percentage of symptomatic PVL-SA colonized children. More than 50% of severe infections might be prevented by prompt testing for PVL-SA in individuals with a history of abscesses or furunculosis, followed by decolonization measures.