Cribratge neonatal de la hipoacusia / Cribado neonatal de la hipoacusia / Newborn hearing screening

Objectiu. Avaluació d’un mètode senzill per al cribratge neonatal universal de la hipoacúsia. Mètode. Estudi prospectiu amb otoemissions acústiques evocades (OAE) dels infants nascuts a l’Hospital de Barcelona l’any 2001. Es van fer entre els 3 i els 5 dies de vida en els nadons a terme sans, i abans de l’alta en els prematurs i els ingressats per patologia. En cas d’absència de resposta, unilateral o bilateral, es va fer control a les 2-3 setmanes i als 2 mesos amb OAE. En cas de persistir absents, es va fer control per otorinolaringòleg (ORL) i potencials evocats auditius de tronc cerebral (PEATC). Resultats. Es van fer OAE al 97% dels 2.027 nadons nascuts l’any 2001. En 11 (0.5%) les OAE persistien absents bilaterals en el control als 2 mesos, i després de la revisió per ORL es va diagnosticar hipoacúsia en 3 (1.5‰ dels nascuts vius). Els altres 8 (4‰), s’han de considerar com a falsos positius. En 22 nens amb resposta unilateral absent no es va aconseguir control. Conclusions. Les OAE són un mètode senzill i útil per al diagnòstic precoç de la hipoacúsia neonatal. S’ha de minimitzar el nombre de falsos positius. S’ha de transmetre als pediatres el benefici dels controls, abans dels 3 mesos, amb OAE dels infants amb absència de resposta unilateral o bilateral, i amb PEATC en cas de persistir absents (AU)

Objetivo. Evaluación de un método sencillo para el cribado neonatal universal de la hipoacusia. Método. Estudio prospectivo con otoemisiones acústicas evocadas (OAE) de los recién nacidos del Hospital de Barcelona en el año 2001. Realizadas a los 3-5 días de vida en los nacidos a término sanos, y antes del alta en los prematuros y en los ingresados por patología. En caso de ausencia de respuesta, unilateral o bilateral, control a las 2-3 semanas y a los 2 meses con OAE. En caso de persistir ausentes, control por otorinolaringólogo (ORL) i potenciales evocados auditivos de tronco cerebral (PEATC). Resultados. Se realizaron OAE al 97% de los 2027 nacidos en el año 2001. En 11 (0.5%) las OAE persistían ausentes bilateralmente en el control a los 2 meses y, después de la revisión por ORL, en 3 (1.5‰) se diagnosticó hipoacusia. Los 8 restantes (4‰) deben considerarse como falsos positivos. En 22 niños con respuesta unilateral ausente, no se consiguió control. Conclusiones. Las OAE constituyen un método sencillo y útil para el diagnóstico precoz de la hipoacusia neonatal. Debe minimizarse el número de falsos positivos. Debe transmitirse a los pediatras el beneficio de los controles con OAE, antes de los 3 meses, de los niños con ausencia de respuesta unilateral o bilateral, y con PEATC en caso de persistir ausentes (AU)

Objective. Evaluation of an easy-to-use test for universal newborn hearing screening Method. Prospective study using evoked otoacoustic emissions (EOAE) in newborns at Hospital de Barcelona during 2001. EOAE were performed on the 2nd or 3rd days of life in normal term newborns, and before discharge from the neonatal unit in premature infants and in term infants with perinatal complications. A repeat EOAE test was performed at 2-3 weeks and at 2 months in those infants with unilateral or bilateral absence of response. Those cases that failed the second test underwent brain auditory evoked potential (BAEP) as diagnostic procedure and were referred to otolaryngology for evaluation. Results. EOAE were performed in 97% of 2027 newborns. In 11 of them (0.5%), EOAE showed bilateral hearing loss at 2 months of age. After examination by otolaryngology and after undergoing BAEP, 3 infants (0.15%) were diagnosed with hearing loss. The other 8 infants (0.4%) were considered false positives. In 22 infants with unilateral absence of response, a follow-up test was not performed. Conclusions. EOAE are an easy and useful method for early diagnosis of neonatal hearing loss. False positives must be minimized. Pediatricians must be aware of the need to perform follow-up EOAE before 3 months of age to all infants with unilateral or bilateral absence of response (AU)

Outbreaks of influenza A virus infection in neonatal intensive care units.

BACKGROUND: Outbreaks of nosocomial influenza virus infections have been described rarely during childhood and even less so in the neonatal period. METHODS: We report 30 neonates admitted to 2 neonatal intensive care units with nosocomial influenza A virus infection, which occurred in 2 outbreaks during 1999. Risk factors for infection were evaluated, and control measures were adopted. Virus was detected by indirect immunofluorescence antibody screen. Any infant with nasopharyngeal aspirate positive for influenza A virus was considered infected. RESULTS: Of 95 infants screened 30 were positive for influenza A virus (31.5%). Mean birth weight was 1622 g, and mean gestational age was 31 weeks in the infected group. In the noninfected group mean birth weight was 2594 g and mean gestational age was 36.4 weeks. Low birth weight, short gestational age, twin pregnancy and mechanical ventilation were identified as risk factors for infection. Clinical symptoms were seen in 22, and 8 were asymptomatic. Clinical features were predominantly respiratory and digestive. The outcome was favorable in all cases. CONCLUSIONS: Infection by influenza virus has to be considered as a possible cause of nosocomial infection in the neonatal period. Control measures and prevention are important.