Secondary Gains of Strategies to Prevent COVID-19 Infection in Neonatal Intensive Care Unit: Has the Frequency of Healthcare-Associated Infections Decreased?

OBJECTIVE: To compare the frequency and distribution of healthcare-associated infections (HAI) in the neonatal intensive care unit (NICU) during COVID-19 infection. METHODS: We compared all cases hospitalized in the NICU and diagnosed with HAIs between 1 March - 1 September 2019 (pre-COVID-19 pandemic) and 1 March - 1 September 2020 (during the COVID-19 pandemic). RESULTS: We evaluated a total of 957 babies, 427 babies in the pre-COVID-19 period and 530 babies during the COVID-19 pandemic. HAIs were determined in 47 patients (60 attacks) and 39 patients (44 attacks) in the pre-COVID-19 period and during the COVID-19 period, respectively. HAIs incidence density (per1000 hospitalization days) was found 5.43 in pre-COVID-19 period and 4.87 in COVID-19 period. During the COVID-19 period, there was a significant decrease in the HAI incidence density and bloodstream infection (P = 0.009). CONCLUSIONS: COVID-19 infection prevention strategies helped reduce the frequency of HAIs especially in bloodstream infection in NICU.

A Displaced Mass in the Abdomen, Torsioned Ovary Cyst.

Ovarian cysts are one of the most common pathologies in the infancy period. Approximately 15% of intraabdominal masses seen in this period are genital origined and one-third of these masses are ovarian cysts. The incidence of ovarian cysts has been reported as 1 in 2500 live births. The most common complications in ovarian cysts are torsion and bleeding. Fetal ovarian cysts usually regress spontaneously in complicated cysts; laparoscopic or open surgery can be applied. A female infant with a diagnosis of intraabdominal cystic mass, suspicion of duodenal atresia, and mesenteric cyst made based on a prenatal ultrasonographic imaging was hospitalized in the neonatal intensive care unit for examination and treatment. The abdominal ultrasonography revealed a cystic lesion in the lower left quadrant. The patient was evaluated with abdominal CT for detailed evaluation 1 day later and revealed a cystic lesion in the right upper quadrant. The displacement of the cystic mass conducted the differential diagnosis in favor of mesenteric cyst and ovarian torsion. Laparoscopic surgery was performed for examination and treatment. It was observed that the left ovary was torsioned and displaced. Ovarian cysts are the most frequently observed masses among prenatal cystic masses in female fetuses. It should be kept in mind that cystic masses detected in the prenatal period may often be ovarian cysts and that these cysts can be displaced in the abdomen while torsion, and a treatment plan should be determined according to the clinical findings of the patient.

COVID-19 Management in Newborn Babies in the Light of Recent Data: Breastfeeding, Rooming-in and Clinical Symptoms.

COVID-19 infection proceeds to spread rapidly, it has affected approximately 22 million people and resulted in 770.000 deaths worldwide so far (18 August 2020). The effect of COVID-19 infection on newborn babies still remains unclear. There is limited data regarding the effect of the virus in fetal life and among neonates after birth. Due to insufficient data, an ideal management method or treatment and follow-up guideline for disease in newborn babies cannot be established. In the recent three studies with the highest number of cases, it is reported that mothers who had COVID-19 infection in the last trimester, can breastfeed their babies if they comply with the appropriate hygiene and transmission prevention rules. It is also reported that pregnant women who got infected during pregnancy, have higher rates of maternal mortality, preterm birth frequency and cesarean delivery. Moreover it is asserted that vertical transmisson of the virus is possible and the babies who have community-acquired COVID-19 infection after birth often have symptoms of fever, hypoxemia, cough, tachypnea, less frequently feeding difficulty, retraction, ral, nasal congestion and exanthema. Topics as; its transmission via vaginal secretions during vaginal delivery, presence of the virus in breast milk and whether it has a teratogenic effect in intrauterine period, have not been fully explained. In this study, it is aimed to review the studies on newborn babies with COVID-19 infection and to compile the epidemic data, clinical findings, diagnosis and current information recommended for treatment. Although there is a limited number of published data on babies of mothers who had COVID-19 infection in the last period of pregnancy and babies who had infection in the neonatal period, the effects of the virus on the fetus in the early period of pregnancy and the long-term problems of newborn babies remain unknown.