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2.
Acta bioquím. clín. latinoam ; Acta bioquím. clín. latinoam;54(4): 407-414, jul. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1149030

ABSTRACT

Resumen La identificación inequívoca del antígeno D en medicina transfusional es de vital importancia para evitar reacciones postransfusionales y la enfermedad hemolítica del recién nacido. Es común el uso de reactivos serológicos monoclonales o tarjetas de gel y su interpretación está definida por cruces, de acuerdo con la reacción serológica. El propósito de este estudio fue determinar la frecuencia del factor Rh y las variantes del antígeno D en una población afroecuatoriana. Se trató de un estudio descriptivo, transversal con muestreo aleatorio simple de 541 pobladores. Para la tipificación del factor Rh se utilizó la metodología en tubo con antisueros monoclonales y para la detección de las variantes de D se utilizaron tarjetas de gel IDCoombs Anti-IgG. Las lecturas se verificaron mediante el análisis del índice kappa. Se aplicó estadística descriptiva y el análisis de Chi cuadrado para establecer la relación de las variables y su significación. Se identificó una frecuencia del 92% de individuos Rh(D) positivo y un 8% Rh(D) negativo. El 4,80% de los individuos presentaban la variante D débil y el 79% reacciones serológicas entre 2 y 3(+) indicativas de otras variantes del antígeno D. El fenotipo más común fue el R0/R0. Estos datos demuestran la necesidad de confirmar la existencia de variantes del antígeno D en esta población para un mejor manejo de la sangre. Una limitante constituye la disponibilidad de técnicas moleculares para la genotipificación de D; sin embargo, se podría implementar la fenotipificación RHCE como estrategia pretransfusional.


Abstract The unequivocal identification of D antigen in transfusion medicine is of vital importance to avoid post-transfusion reactions and hemolytic disease of the newborn. The use of monoclonal serological reagents or gel cards is common and their interpretation is defined according to the serological reaction by crosses. The purpose of this study was to determine the frequency of Rh factor and D antigen variants in the Afro-Ecuadorian population. This was a descriptive, cross-sectional study with simple random sampling of 541 residents. Tube typing with monoclonal antisera was used to typify Rh factor and ID-Coombs Anti-IgG gel cards were used to detect D variants, and the readings were verified by analysis of the kappa index. Descriptive statistics and Chi-square analysis were applied for the relationship of the variables and their significance. A frequency of 92% of Rh(D) positive individuals and 8% Rh(D) negative individuals were identified. Almost 5% (4.80%) of the individuals presented the weak D variant and 79% serological reactions between 2-3(+) indicative of other D antigen variants, the most common phenotype being R0/R0. These data demonstrate the need to confirm the existence of D antigen variants in this population for better management and availability of blood. A limitation is the availability of molecular techniques for D genotyping, however, RHCE phenotyping could be implemented as a pretransfusion strategy.


Resumo A identificação inequívoca do antígeno D na medicina transfusional é de vital importância para evitar reações pós-transfusionais e a doença hemolítica do recém-nascido. É comum o uso de reagentes sorológicos monoclonais ou cartões de gel e sua interpretação é definida por cruzamentos de acordo com a reação sorológica. O objetivo deste estudo foi determinar a frequência do fator Rh e as variantes do antígeno D numa população afro-equatoriana. Foi um estudo descritivo, transversal, com amostragem aleatória simples de 541 residentes. Para a tipagem do fator Rh foi utilizada a metodologia em tubo com anti-soros monoclonais e para a detecção das variantes de D, os cartões de gel ID-Coombs Anti-IgG. As leituras foram verificadas por análise do índice kappa. Foi aplicada estatística descritiva e para estabelecer a relação das variáveis e sua significação se utilizou a análise do qui-quadrado. Identificando uma frequência de 92% dos indivíduos Rh (D) positivos e 8% Rh (D) negativos. 4,80% dos indivíduos apresentavam a variante D fraca e 79% reações sorológicas entre 2 e 3(+) indicativas de outras variantes do antígeno D, sendo o fenótipo mais comum o R0/R0. Esses dados demonstram a necessidade de confirmar a existência de variantes do antígeno D nessa população para melhor gerenciamento e disponibilidade de sangue. Uma limitação é a disponibilidade de técnicas moleculares para a genotipagem de D, no entanto, a fenotipagem de RHCE poderia ser implementada como uma estratégia de pré-transfusão.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Rh-Hr Blood-Group System/analysis , Rh-Hr Blood-Group System/blood , Antigens/analysis , Population , Rh-Hr Blood-Group System , Blood , Infant, Newborn , Cross-Sectional Studies , Transfusion Medicine , Indicators and Reagents , Infant, Newborn, Diseases/prevention & control , Antigens
3.
Rev. cuba. pediatr ; 91(3): e616, jul.-set. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1093716

ABSTRACT

Introducción: Las infecciones de piel y partes blandas constituyen una de las causas más frecuentes de consulta pediátrica, de lo cual no está exento el recién nacido, que por sus peculiaridades anatómicas, fisiológicas e inmunológicas, pueden convertirse en afecciones letales. Objetivo: Describir aspectos clínicos y epidemiológicos de los recién nacidos con infecciones de piel y partes blandas. Métodos: Se realizó un estudio observacional, prospectivo y transversal en 256 pacientes que ingresaron en el Departamento de Neonatología del Hospital Pediátrico Universitario William Soler de enero de 2013 a diciembre de 2015. Se determinó la incidencia de las infecciones de piel y partes blandas, formas clínicas de presentación, edad, sexo, estadía, terapéutica utilizada y microorganismos aislados en hemocultivo. Resultados: En la muestra, 95,3 por ciento de los neonatos tenían más de 7 días de nacidos y 59,0 por ciento eran hembras. La tasa de incidencia fue de 16,1 × 100 ingresos y el 75,0 por ciento presentaba mastitis. El microorganismo más aislado en hemocultivos fue Staphylococcus aureus. El 60,9 por ciento de los pacientes recibieron monoterapia con Cefazolina. Conclusiones: La incidencia de las infecciones de piel y partes blandas fue mayor en el año 2014; los recién nacidos inician la enfermedad en la segunda semana de vida, en el sexo femenino, con una estadía hospitalaria menor de una semana. El microorganismo más aislado en hemocultivos es Staphylococcus aureus. Más de la mitad de los pacientes reciben monoterapia con Cefalosporina de primera generación como terapéutica con una evolución favorable(AU)


Introduction: Skin and soft tissue infections constitute one of the most frequent causes of pediatric consultations. Newborns are not exempt of that since their anatomic, physiological and immunological peculiarities can help to become those infections in letal ones. Objective: To describe clinical and epidemiological aspects of newborns presenting skin and soft tissue infections. Methods: An observational, prospective and cross-sectional study was carried out in 256 patients admitted in the Neonatology Department of William Soler Pediatric University Hospital from January, 2013 to Decmeber, 2015. There were determined: the incidence of skin and soft tissue infections, the clinical kinds, age, sex, stay, used therapy, microorganisms isolated in hemocultures. Results: In the sample, 95.3 percent of the newborns were of more than 7 days alive and 59.0 percent were female. The incidence rate was of 16.1 × 100 admissions, and 75.0 percent presented mastitis. The most isolated in hemocultures microorganism was Staphylococcus aureus. 60.9 percent of the patients had monotherapy with Cefazolin. Conclusions: The incidence of skin and soft tissue infections was higher in 2014; the disease onset in newborns in the second week of life, in females, with a hospital stay of less than a week. The most isolated in hemocultures microorganism is Staphylococcus aureus. More tan half of the patients undergone monotherapy with first generation Cephalosporines as a therapy with a favorable evolution(AU)


Subject(s)
Humans , Male , Female , Infant, Newborn , Skin Diseases, Infectious/complications , Infant, Newborn, Diseases/prevention & control , Cross-Sectional Studies , Prospective Studies , Observational Study , Mastitis/prevention & control
4.
Rev. argent. microbiol ; Rev. argent. microbiol;51(2): 157-163, jun. 2019. tab
Article in Spanish | LILACS | ID: biblio-1013367

ABSTRACT

La etiología que conduce al daño neonatal es multifactorial, y los procesos infecciosos pueden estar implicados en él. El objetivo de este estudio fue identificar microorganismos del tracto genital materno asociados con el daño neonatal, a fin de prevenir futuras complicaciones perinatológicas. Se estudiaron 711 embarazadas que concurrieron entre enero de 2010 y julio 2013 al consultorio externo de Obstetricia del Hospital de Clínicas de la UBA para sus controles prenatales, y cuyos partos también tuvieron lugar en dicho nosocomio. En la sangre del cordón umbilical se investigó la presencia de Ureaplasma urealyticum y Mycoplasma hominis mediante el cultivo con sustratos metabólicos (Micofast-Biomerieux), y la de Trichomonas vaginalis por PCR, con primers específicos. El estudio microbiológico del contenido vaginal se efectuó en 288 de las embarazadas en la semana 35 a 37. Se empleó la metodología convencional, a la que se agregó el cultivo en tioglicolato modificado para T. vaginalis. Se investigó la presencia de estreptococos grupo B (EGB) en hisopado anorrectaly de introito vaginal, utilizando enriquecimiento en caldo selectivo y posterior siembra en medio cromogénico. Se utilizaron los test de χ² Yates y de Fisher para muestras independientes, considerándose significativo p < 0,05. La vaginosis bacteriana (VB) se relacionó significativamente con el daño neonatal (p = 0,02), al igual que la presencia de M. hominis (p = 0,03) y de T. vaginalis (p = 0,03) en la sangre del cordón umbilical. Las complicaciones predominantes fueron el parto pretérmino, la rotura prematura de membrana (RPM), el bajo peso y un valor de Apgar <7. No se asoció al daño neonatal la presencia de U. urealyticum (p = 0,35) en el cordón umbilical, ni la de Candidaspp. (p = 0,94) o EGB (p = 0,18) en el tracto genital de las madres. Dado que ciertas alteraciones en la microbiota del tracto genital materno se relacionaron con el dano neonatal, consideramos de fundamental importancia realizar el estudio microbiológico del contenido vaginal durante el embarazo, para prevenir posibles complicaciones maternas y perinatológicas.


The etiology leading to neonatal damage is multifactorial, being genital infections one of the causes. The objective of the study was to identify microorganisms of the maternal genital tract that are associated with neonatal damage, in order to prevent future perinatal complications. Seven hundred and eleven pregnant patients attended their prenatal control during the period January 2010-July 2013. Ureaplasma urealyticum and Mycoplasma hominis presence was investigated in umbilical cord blood by metabolic substrates (Micofast-Biomerieux) and that of T. vaginalis, by PCR using specific primers. The microbiological study of the vaginal contents of 288 pregnant patients at weeks 35 to 37 was performed by conventional methods, adding the modified thioglycolate culture for T. vaginalis. Group B streptococcus (GBS) was investigated in anorectal and vaginal introitus swabs, using selective broth enrichment and subsequent isolation in chromogenic medium. The χ² Yates test and Fisher's test were used for independent samples. A p value <0.05 was considered statistically significant. The pathogens significantly related to neonatal damage were M. hominis (p = 0.03), T. vaginalis (p = 0.03), and BV (p = 0.02). Main complications were preterm birth, premature rupture of membranes (PRM), low weight and Apgar score <7. U. urealyticum (p = 0.35), Candidaspp. (p = 0.94) and GBS (p = 0.18) were not related to neonatal damage. Since different microorganisms of the maternal genital tract were related to neonatal damage, it is very important to perform the microbiological study of vaginal contents during pregnancy to prevent possible maternal and perinatal complications.


Subject(s)
Humans , Female , Pregnancy , Umbilical Cord/microbiology , Vaginosis, Bacterial/microbiology , Fetal Blood/microbiology , Microbiological Techniques/methods , Vaginosis, Bacterial/complications , Infant, Newborn, Diseases/prevention & control
5.
Rev. bras. enferm ; Rev. bras. enferm;72(supl.3): 9-16, 2019.
Article in English | BDENF, LILACS | ID: biblio-1057715

ABSTRACT

ABSTRACT Objective: To understand factors interfering with the attendance of quilombola children to growth and development follow-up appointments. Method: It is a qualitative research based on Symbolic interactionism, during which 14 mothers of children bellow 1 year-old were interviewed, who attended to the Family Health Unit at Ilha de Maré, Bahia, Brazil. Results: Appointment attendance is affected by factors intrinsic to mothers (meaning of child health follow-up; association between appointments and children falling ill; personal issues) and extrinsic factors, related to the service (availability, long waiting time for appointments and its quality). Final considerations: An administration prioritizing the service's organization is required, which can prioritize attendances and the reduction of waiting time, specially given the personal issues that compromise going to the unit.


RESUMEN Objetivo: Identificar los factores que interfieren en la asiduidad de niños quilombolas en las consultas de seguimiento para el crecimiento y desarrollo. Método: Investigación cualitativa con base en el Interaccionismo Simbólico, en la cual se entrevistó 14 madres de niños menores de un año de edad y que frecuentaban la Unidad de Salud de la Familia de Ilha de Maré, Bahia, Brasil. Resultados: La asiduidad en las consultas sufre influencia de factores intrínsecos a las madres -significado de seguimiento para la salud infantil, asociación de las consultas con la enfermedad del niño; cuestiones personales- y de factores extrínsecos relativos al servicio -disponibilidad de agenda, mucho tiempo de espera para las consultas y su calidad-. Consideraciones Finales: Es necesario haber una gestión que priorice la reorganización del servicio, con mayor prioridad a las agendas y al perfeccionamiento profesional, teniendo en cuenta la mejora de la calidad de la atención médica prestada y la reducción del tiempo de espera, principalmente considerando las cuestiones personales que les comprometen venir a la unidad.


RESUMO Objetivo: Apreender fatores que interferem na assiduidade de crianças quilombolas às consultas de acompanhamento do crescimento e desenvolvimento. Método: Pesquisa qualitativa ancorada no Interacionismo Simbólico, durante a qual foram entrevistadas 14 mães de crianças menores de um ano e que frequentavam a Unidade de Saúde da Família de Ilha de Maré, Bahia, Brasil. Resultados: A assiduidade às consultas sofre influência de fatores intrínsecos às mães (significado do acompanhamento à saúde infantil; vinculação das consultas ao adoecimento da criança; questões pessoais) e fatores extrínsecos relativos ao serviço (disponibilidade de agendamento, amplo tempo de espera para as consultas e qualidade das mesmas). Considerações Finais: Urge uma gestão que priorize a reorganização do serviço, com prioridade aos agendamentos e o aprimoramento profissional, tendo em vista a melhoria da qualidade do atendimento e a redução do tempo de espera, principalmente considerando as questões pessoais que comprometem a ida à unidade.


Subject(s)
Humans , Pregnancy , Adolescent , Adult , Young Adult , Appointments and Schedules , Patient Compliance , Indigenous Peoples , Infant, Newborn, Diseases/prevention & control , Brazil , Ethnicity , Child Health Services , Risk Factors , Follow-Up Studies , Health Services, Indigenous , Infant, Newborn, Diseases/ethnology
6.
Rev. chil. infectol ; Rev. chil. infectol;34(4): 374-376, ago. 2017.
Article in Spanish | LILACS | ID: biblio-899727

ABSTRACT

Resumen El fenómeno migratorio en Chile ha aumentado en forma exponencial en los últimos años y con ello las mujeres embarazadas extranjeras en las maternidades de nuestro país. El conocer el estado de salud y el tamizaje de enfermedades infecciosas en la madre, permitiría tomar conductas preventivas de gran impacto en el recién nacido.


Over the past few years immigration has become an important issue in Chile. Particular attention should be paid in foreign pregnant mothers. Infectious diseases screening in this group greatly reduce the risk of transmission to the fetus with appropriate therapy.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pregnancy Complications, Infectious/prevention & control , Infectious Disease Transmission, Vertical/prevention & control , Emigration and Immigration/statistics & numerical data , Infant, Newborn, Diseases/prevention & control , Chile
7.
Rev. ADM ; 73(6): 320-323, nov.-dic. 2016. ilus, tab
Article in Spanish | LILACS | ID: biblio-869344

ABSTRACT

Cuando se encuentran dientes presentes al nacimiento es frecuente que los médicos pediatras interconsulten con el odontólogo, dichos dientes reciben el nombre de natales y neonatales de acuerdo con el momento en el cual hacen su aparición, si los dientes se encuentran presentes al nacimiento se les denomina natales y si aparecen durante el primer mes de vida se les llama neonatales. No es raro que los dientes natales y neonatales carezcan de raíz, y debido a su débil unión con eltejido gingival es posible que estos dientes puedan desalojarse y serbroncoaspirados o deglutidos por el menor durante la alimentación al seno materno. Si bien los dientes natales y neonatales no constituyen una entidad patológica per se, existen algunos síndromes genéticos que entre sus características se encuentran los dientes natales o neonatales.


When teeth are present at birth, pediatricians frequently seek the opinionof a dentist. These teeth are known as natal or neonatal depending onwhether they are present at birth or appear during the fi rst month oflife. It is not uncommon for natal and neonatal teeth to have no root,and due to their weak bond to the gingival tissue they can come looseand be breathed in or swallowed by the child during breast feeding.While natal and neonatal teeth are not a pathological entity per se,there are certain genetic syndromes whose features include natal orneonatal teeth.


Subject(s)
Humans , Male , Infant, Newborn , Natal Teeth/surgery , Natal Teeth/physiology , Natal Teeth , Infant, Newborn, Diseases/diagnosis , Infant, Newborn, Diseases/prevention & control , Oral Surgical Procedures/methods , Vitamin K/administration & dosage
8.
IJRM-Iranian Journal of Reproductive Medicine. 2016; 14 (5): 309-316
in English | IMEMR | ID: emr-180247

ABSTRACT

Background: Preterm birth is the major cause of neonatal mortality and morbidity


Objective: The aim of this study was to evaluate the effect of prophylactic vaginal progesterone on decreasing preterm birth rate and neonatal complications in a high-risk population


Materials and Methods: A randomized, double-blind, placebo-controlled study was performed on 100 high-risk singleton pregnancies. Vaginal suppository progesterone [400 mg] or placebo was administered daily between 16-22 wks to 36 wks of gestation. Progesterone [n=50] and placebo [n=50] groups were compared for incidence of preterm delivery and neonatal complications


Results: The preterm birth rate was 52%. Preterm birth rate before the 37 wks of gestation [68% vs. 36%: RR=1.89, 95% CI: 1.25-2.86] and also before the 34 wks of gestation [42% vs. 18%: RR=2.33, 95% CI: 1.19-4.58] in placebo group was significantly higher than progesterone group. Our study also showed that the administration of vaginal progesterone was associated with a significant reduction in the risk of birth weight

Conclusion: Prophylactic vaginal progesterone reduced the rate of preterm delivery, the risk of a birth weight

Subject(s)
Adult , Female , Humans , Infant, Newborn , Administration, Intravaginal , Progesterone/therapeutic use , Infant, Newborn, Diseases/prevention & control , Risk Factors , Placebo Effect , Double-Blind Method
9.
Braz. j. infect. dis ; Braz. j. infect. dis;19(3): 272-277, May-Jun/2015. tab, graf
Article in English | LILACS | ID: lil-751877

ABSTRACT

Background: Neonatal infection is a serious public health problem. The aim of this study was to assess the influence of the antenatal care on the risk of early-onset neonatal healthcare associated infection in two Brazilian maternities. Methods: Cohort study - Newborns admitted at two public neonatal intensive care units from 2008 to 2009 were included in the study. Data on antenatal and perinatal variables were collected from maternal prenatal cards and medical charts. Newborns were actively surveyed for early-onset neonatal healthcare associated infection, defined as a neonatal infection diagnosed within 48 h after birth. Multiple logistic regression was used to assess variables independently associated with early-onset neonatal healthcare associated infection. Results: 561 neonate-mother pairs were included in the study. Early-onset neonatal health-care associated infection was diagnosed in 283 neonates (51%), an incidence rate of 43.5/1000 live births. Neonates whose mothers had less then six antenatal visits were under risk significantly higher for early-onset neonatal healthcare associated infection (OR = 1.69, 95% CI = 1.11-2.57), after adjusting for birth weight, membranes ruptured for >18 h, maternal complications during delivery, maternal infection at admission, and hospital where patients received care. Conclusions: The risk of neonatal early-onset neonatal healthcare associated infection was significantly associated with insufficient number of antenatal care visits. Further studies assessing the quality of antenatal care and targeting its improvement are warranted. .


Subject(s)
Female , Humans , Infant, Newborn , Male , Pregnancy , Infant, Newborn, Diseases/diagnosis , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy Complications, Infectious/diagnosis , Prenatal Care/standards , Brazil , Cohort Studies , Communicable Diseases , Intensive Care Units, Neonatal , Infant, Newborn, Diseases/prevention & control , Risk Factors
12.
JAMC-Journal of Ayub Medical College-Abbotabad-Pakistan. 2010; 22 (1): 143-146
in English | IMEMR | ID: emr-143676

ABSTRACT

Perinatal and infant mortality are two major contributors to child mortality in developing world. It is widely recognised that synergistic efforts by paediatric and obstetric healthcare providers result in improvement of neonatal and infant survival. Close working relationship between the 2 disciplines with attendance of all high risk births by paediatric healthcare providers and routine examination of all neonates is required for this purpose. Objectives were to compare 2 continuums of 100 neonatal cases for detection of serious neonatal disease. One set of neonates being examined by neonatal/paediatric service and other without this service in place. One hundred Neonatal Exam sheets were selected randomly from records of 2007-2008 and compared with 100 Neonatal Exam Sheets of 2006-2007. Records were analysed for detection of serious neonatal conditions at 24 hours age. Data was analysed using MS EXCEL. Odds ratio was calculated for each disease with Haldane correction. Odds ratio was significantly higher for detection of serious neonatal diseases in 2007-2008 group when neonatal service was actively involved in newborn examinations of all neonates. Highest odds ratios were obtained for detection of Heart Murmur and neonatal sepsis. Newborn Examination within 24-48 hours of birth by trained neonatal healthcare provider is paramount for adequate detection of serious neonatal diseases. Such services should be instituted in all obstetric units for better neonatal outcome


Subject(s)
Humans , Female , Male , Infant, Newborn, Diseases/prevention & control , Infant Mortality , Perinatal Mortality , Neonatal Screening , Pediatrics
13.
Femina ; 37(7): 361-365, jul. 2009. tab
Article in Portuguese | LILACS | ID: lil-537576

ABSTRACT

Embora a cultura reto-vaginal para estreptococo do grupo B (EGB), ou Streptococcus agalactiae, entre 35 e 37 semanas pareça ser o método mais sensível e específico para detecção das gestantes colonizadas na hora do parto, a decisão de solicitar esse exame rotineiramente, como uma medida de prevenção para infecção neonatal, é controversa. A prevalência mundial de gestantes colonizadas por EGB encontra-se em torno de 20 porcento. A transmissão vertical ocorre na metade dos casos. No entanto, estima-se que a incidência de infecção neonatal por EGB seja de 1 a 2 casos por 1.000 nascidos vivos. O objetivo desta revisão é identificar e sintetizar evidências relevantes sobre EGB durante a gravidez, fatores de risco, etiologia, incidência e complicações da infecção neonatal, limitações da cultura para EGB, indicações da profilaxia antibiótica intraparto (PAI), antibióticos preconizados e seus efeitos adversos. As bases de dados Medline, Lilacs/Scielo e Biblioteca Cochrane foram consultadas por meio de pesquisa com os termos gravidez, estreptococo do Grupo B e infecção neonatal.


Although the cultures of the vagina and rectum for streptotoccus group B (GBS) or streptococcus agalactiae between 35 e 37 weeks of gestation appears to achieve the best sensitivity and specificity for detection of colonized women at the time of delivery, the decision of requesting streptotoccus group B (GBS) cultures for all pregnant women to prevent neonatal infection is controversial. The worldwide prevalence of pregnant women colonized by GBS is nearly 20 percent. Vertical transmission occurs in health cases. However, it is estimated that incidence of neonatal infection for GBS is 1 to 2 cases per 1.000 birth lives. The objective of this review is to identify and to synthesize relevant evidence about screening for GBS during pregnancy, the risk factors associated with early neonatal infection, etyology, incidence and neonatal infection complications, culture limitations, indications of intrapartum antibiotics prophylactic (IAP) for group B streptococcus colonisation, indicated antibiotics and their adverse effects. Medline, Lilacs/Scielo and Cochrane Library were consulted by mean of a search with the keywords pregnancy, streptococcus group B and neonatal infection.


Subject(s)
Female , Pregnancy , Infant, Newborn , Pregnancy Complications, Infectious/prevention & control , Infant, Newborn, Diseases/prevention & control , Infectious Disease Transmission, Vertical , Streptococcal Infections/diagnosis , Streptococcal Infections/prevention & control , Streptococcal Infections/transmission , Chemoprevention , Risk Factors , Streptococcus agalactiae
14.
Rev. chil. pediatr ; 79(5): 462-470, oct. 2008. ilus, tab
Article in Spanish | LILACS | ID: lil-518975

ABSTRACT

Group B Streptococcus is one of the leading bacterias causing early onset neonatal sepsis. It constitutes an important factor of neonatal morbidity and mortality and high costs in health. Many strategies have been formulated to avoid vertical transmission from the colonized mother to the newborn, in an attempt to prevent infection of the infant. The most used nowadays is antibiotic prophylaxis given to the mother during labor, depending on the results of recto-vaginal culture taken during 35 to 37 weeks of gestation. This strategy has importantly diminished the prevalence of early onset neonatal sepsis by this agent, although there is still concern about the potential generation of antibiotic resistance and drug-induced adverse reactions in the mother. New techniques for prevention are being developed, such as vaccines against Streptococcus. In the newborn, infection caused by Streptococcus has a broad spectrum of clinical manifestations, like sepsis and meningitis which are the most frequent and lethal. Neurological sequelae are common among the survivors, so an early suspicion of disease must lead to a prompt antibiotic treatment.


El Streptococcus grupo B (SGB) es uno de los principales agentes causales de sepsis neonatal precoz, siendo un importante factor de morbimortalidad neonatal y de costos en salud pública. Se han implementado múltiples estrategias para evitar la transmisión vertical desde la madre colonizada a su recién nacido, de modo de prevenir la infección de éste último. La más usada en la actualidad es la profilaxis antibiótica administrada a la madre en el momento del parto dependiendo del resultado de un cultivo perineal realizado entre las semanas 35 y 37 de gestación. Mediante esta estrategia se ha logrado disminuir de manera importante la incidencia de la sepsis neonatal por este agente, pero existen aprehensiones acerca de la posible generación de resistencia antibiótica o reacciones adversas a fármacos por parte de la madre. Por esto último, nuevas técnicas de prevención se encuentran en estudio, como las vacunas contra el SGB. En los recién nacidos la infección por Streptococcus agalactiae puede manifestarse de diversas maneras, siendo la sepsis y la meningitis las más frecuentes y mortales. El porcentaje de secuelas entre los sobrevivientes es elevado, por lo que ante la sospecha precoz de infección debe iniciarse tratamiento antibiótico a la brevedad.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant, Newborn, Diseases/microbiology , Infant, Newborn, Diseases/prevention & control , Streptococcal Infections/prevention & control , Streptococcus agalactiae/pathogenicity , Antibiotic Prophylaxis , Pregnancy Complications, Infectious/prevention & control , Infectious Disease Transmission, Vertical , Streptococcal Infections/transmission , Risk Factors , Sepsis/microbiology , Sepsis/prevention & control , Streptococcus agalactiae/growth & development
15.
Salud pública Méx ; 50(2): 155-161, mar.-abr. 2008. graf, tab
Article in Spanish | LILACS | ID: lil-479087

ABSTRACT

OBJETIVO: Conocer el criterio para la quimioprofilaxis en mujeres embarazadas colonizadas con Streptococcus agalactiae (SGB) y las repercusiones de la infección en México. MATERIAL Y MÉTODOS: Se identificó a mujeres embarazadas con SGB mediante el cultivo cervicovaginal y/o urinario en una revisión de cinco años. Se formaron dos grupos: con uso de quimioprofilaxis, el primero, y sin uso de la misma, el segundo. Con base en la utilización de la prueba de ji cuadrada se determinó la diferencia de proporciones. La aproximación de ji cuadrada para la distribución de Poisson comparó los promedios de la infección neonatal. RESULTADOS: Se notificaron 274 cultivos positivos para SGB en 261 pacientes; 165 (60.2 por ciento) cervicovaginales, 109 (39.7 por ciento) urinarios, y en 13 pacientes (4.7 por ciento) se obtuvo resultado positivo en ambos. De las 261 pacientes, 53 (5.6 por ciento) recibieron profilaxis intraparto (p< 0.05) y 29.2 por ciento se trató de forma correcta según los criterios internacionales. CONCLUSIONES: No existen criterios establecidos para la búsqueda intencionada de SGB en la mujer embarazada mexicana.


OBJECTIVE: To know the criteria which determine the chemoprophylaxis on pregnant women colonized by Streptococcus agalactiae (GBS) and the impact in our environment. MATERIAL AND METHODS: A retrospective analysis, identifying pregnant women with isolation of Streptococcus agalactiae on screening cultures, cervical swabs and urine culture. Two groups were analyzed, group 1 received chemoprophylaxis, and group 2 without chemoprophylaxis. Chi square was used to asses the difference between proportions. Chi square approximation to Poisson distribution was used to compare the means of neonatal infection. RESULTS: A total of 274 cultures were reported with GBS isolation, on 261 patients; 165 (60.2 percent) cervical swabs, 109 (39.7 percent) urine culture and 13 patients from 274 (4.7 percent) had positive culture on both specimens. Of this 261 patients, 53 (5.6 percent) received chemoprophylaxis during labor (p<0.05). The CDC criteria were followed accuracy on 29.2 percent. CONCLUSIONS: There have not been established criteria for screening colonization by GBS in Mexican pregnant women.


Subject(s)
Adolescent , Adult , Female , Humans , Infant, Newborn , Male , Middle Aged , Pregnancy , Guideline Adherence , Infant, Newborn, Diseases/prevention & control , Streptococcal Infections/prevention & control , Streptococcus agalactiae , Internationality , Retrospective Studies , Streptococcus agalactiae/isolation & purification
16.
Femina ; 35(10): 657-662, out. 2007. tab
Article in Portuguese | LILACS | ID: lil-480245

ABSTRACT

O Estreptococo do Grupo B é relevante causa de infecção neonatal representada por pneumonia, meningite ou sepse. O trato gastrointestinal materno é o seu reservatório natural e provavelmente é a fonte de colonização vaginal. A transmissão ao recém-nascido ocorre principalmente durante o trabalho de parto ou rotura de membranas. Protocolos de recomendações para rastreamento e antibioticoprofilaxia desta infecção foram criados sendo o último em 2002 pelo CDC e ACOG que recomenda o rastreamento universal de gestantes entre 35 e 37 semanas e a penicilina como antibiótico de escolha. Em nosso meio ainda não há consenso sobre o rastreamento. Há poucos estudos de prevalência do Estreptococo do Grupo B em nossa população de gestantes, o que torna difícil a avaliação do custo-benefício de medidas de prevenção preconizadas nos protocolos internacionais.


Subject(s)
Female , Pregnancy , Infant, Newborn , Chemoprevention , Pregnancy Complications, Infectious/prevention & control , Infant, Newborn, Diseases/prevention & control , Infectious Disease Transmission, Vertical , Streptococcal Infections/prevention & control , Streptococcal Infections/transmission , Mass Screening , Streptococcus agalactiae
17.
Pediatria (Säo Paulo) ; 29(2): 117-128, 2007.
Article in Portuguese | LILACS | ID: lil-471432

ABSTRACT

Objetivo: avaliar os principais fatores de risco associados a alterações do desenvolvimento infantil. Fontes pesquisadas: as bases de dados MEDLINE, LILACS e SciELO entre janeiro de 1985 e janeiro de 2007. Síntese dos dados: os avanços tecnológicos das últimas décadas amplificaram o entendimento acerca do desenvolvimento infantil...


Objective: to evaluate the main risk factors associated with changes in child development. Data sources: Medline, Lilacs and Scielo databases between January 1985 and January 2007. Data synthesis: the technological advance over the last few decades increased our understanding about child development...


Subject(s)
Humans , Infant, Newborn , Child Development , Infant, Newborn, Diseases/prevention & control , Primary Health Care , Early Intervention, Educational , Pediatrics , Risk Factors
19.
São Paulo med. j ; São Paulo med. j;123(4): 198-200, jul. 2005.
Article in English | LILACS | ID: lil-414416

ABSTRACT

CONTEXTO: Púrpura trombocitopênica neonatal aloimune (PTNA) é uma doença neonatal caracterizada por aloimunização materna contra as plaquetas fetais, que apresentam antígenos herdados do pai. Podem ocorrer hemorragias cerebrais, levando à morte ou a anomalias neurológicas permanentes. RELATO DE CASO: Mulher saudável, de 30 anos, deu à luz, por parto cesariano na 36ª semana de gestação, seu primeiro filho. Com 10 horas de vida, o recém-nascido apresentou petéquias e contagem de 8 x 103 plaquetas/µl no sangue periférico; foi medicado com imunoglobulina e recebeu alta após 18 dias de internação, com 100 x 103 plaquetas/µl. A causa da trombocitopenia não foi elucidada na época. Um ano depois, a criança morreu de neuroblastoma. Como os pais desejavam outro filho, foram encaminhados para investigação da trombocitopenia. Genotipagem plaquetária e pesquisa de anticorpos antiplaquetários foram realizadas, mostrando total falta de concordância entre os sistemas HPA-1 do pai (HPA-1a1a) e da mãe (HPA-1b1b) e anticorpos anti-HPA-1a no soro da mãe. Concluímos que o primeiro bebê nasceu com PTNA. Por isso, na segunda gravidez, a mãe foi tratada com diversas infusões de imunoglobulina intravenosa. Foi realizado cuidadoso monitoramento por ultra-som, com resultados normais para mãe e feto durante a gravidez. O segundo bebê nasceu por cesárea às 39 semanas, apresentando 92 x 103 plaquetas/µl seis horas após o nascimento. As plaquetas do recém-nascido foram genotipadas como HPA-1a1b e o soro da mãe novamente mostrou anticorpos anti-HPA-1a. Não houve hemorragia. A terapia de infusão de imunoglobulina foi efetiva na prevenção da PTNA no segundo filho.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Adult , Antigens, Human Platelet/genetics , Immunoglobulins, Intravenous/therapeutic use , Infant, Newborn, Diseases/immunology , Pregnancy Complications, Hematologic/immunology , Purpura, Thrombocytopenic/congenital , Genetic Testing , Antigens, Human Platelet/immunology , Fatal Outcome , Genotype , Infant, Newborn, Diseases/prevention & control , Isoantibodies/analysis , Isoantibodies/immunology , Neuroblastoma/etiology , Platelet Count , Pregnancy Complications, Hematologic/prevention & control , Purpura, Thrombocytopenic/immunology , Purpura, Thrombocytopenic/prevention & control
20.
Nursing (Ed. bras., Impr.) ; 8(83): 185-189, abr. 2005. tab
Article in Portuguese | LILACS, BDENF | ID: lil-526594

ABSTRACT

Trata-se de um estudo exploratório-descritivo desenvolvido em hospital infantil municipal de Natal. Cinquenta familiares foram entrevistados no momento da triagem neonatal. 68 por cento dos pesquisadores referiram compreender o que significa triagem neonatal, enquanto 32 por cento não possuem informações sobre o exame. 34 por cento afirmaram que o teste é feito para saber se a criança apresentará alguma doença futuramente e 21 por cento, prevenção de doenças. no tocante às doenças detectadas pelo teste, 82 por cento desconhecem, enquanto 10 por cento citaram doença mental. O pediatra foi a principal fonte de informação sobre o teste e a maioria dos pesquisadores gostaria de saber quais doenças podem ser prevenidas com a triagem.


Subject(s)
Humans , Infant, Newborn , Infant, Newborn, Diseases/prevention & control , Neonatal Screening , Brazil , Qualitative Research , Surveys and Questionnaires
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