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Fiocchi, Alessandro, Jan Knol, Sibylle Koletzko, Liam O’Mahony, Nikolaos G. Papadopoulos, Seppo Salminen, Hania Szajewska und Anna Nowak-Węgrzyn. „Early-Life Respiratory Infections in Infants with Cow’s Milk Allergy: An Expert Opinion on the Available Evidence and Recommendations for Future Research“. Nutrients 13, Nr. 11 (26.10.2021): 3795. http://dx.doi.org/10.3390/nu13113795.
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Acute respiratory infections are a common cause of morbidity in infants and young children. This high rate of respiratory infections in early life has a major impact on healthcare resources and antibiotic use, with the associated risk of increasing antibiotic resistance, changes in intestinal microbiota composition and activity and, consequently, on the future health of children. An international group of clinicians and researchers working in infant nutrition and cow’s milk allergy (CMA) met to review the available evidence on the prevalence of infections in healthy infants and in those with allergies, particularly CMA; the factors that influence susceptibility to infection in early life; links between infant feeding, CMA and infection risk; and potential strategies to modulate the gut microbiota and infection outcomes. The increased susceptibility of infants with CMA to infections, and the reported potential benefits with prebiotics, probiotics and synbiotics with regard to improving infection outcomes and reducing antibiotic usage in infants with CMA, makes this a clinically important issue that merits further research.
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Kourtis, Athena P., Jeffrey Wiener, Tiffany S. Chang, Sheila C. Dollard, Minal M. Amin, Sascha Ellington, Dumbani Kayira, Charles van der Horst und Denise J. Jamieson. „Cytomegalovirus IgG Level and Avidity in Breastfeeding Infants of HIV-Infected Mothers in Malawi“. Clinical and Vaccine Immunology 22, Nr. 12 (30.09.2015): 1222–26. http://dx.doi.org/10.1128/cvi.00460-15.
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ABSTRACTCytomegalovirus (CMV) infection is common among infants of HIV-infected mothers in resource-limited settings. We examined the prevalence and timing of infant CMV infection during the first year of life using IgG antibody and avidity among HIV-exposed infants in Malawi and correlated the results with the presence of detectable CMV DNA in the blood. The Breastfeeding, Antiretrovirals and Nutrition (BAN) study randomized 2,369 mothers and their infants to maternal antiretrovirals, infant nevirapine, or neither for 28 weeks of breastfeeding, followed by weaning. Stored plasma specimens were tested for CMV IgG and antibody avidity from a random subset of infants who had been previously tested with blood CMV PCR and had available specimens at birth and at 24 and 48 weeks of age. Ninety-four of 127 infants (74.0%) tested at 24 weeks of age had CMV IgG of low or intermediate avidity, signifying primary CMV infections. An additional 22 infants (17.3%) had IgG of high avidity; 19 of them had CMV DNA detected in their blood, indicating infant infections. Taken together, these results show that the estimated prevalence of CMV infection at 24 weeks was 88.9%. By 48 weeks of age, 81.3% of infants had anti-CMV IgG; most of them (70.9%) had IgG of high avidity. The CMV serology and avidity testing, combined with the PCR results, confirmed a high rate of primary CMV infection by 6 months of life among breastfeeding infants of HIV-infected mothers. The CMV PCR in blood detected most, but not all, infant CMV infections.
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Hernandez-Alvarado, Nelmary, Ryan Shanley, Mark R. Schleiss, Jensina Ericksen, Jenna Wassenaar, Lulua Webo, Katherine Bodin, Katelyn Parsons und Erin A. Osterholm. „Clinical, Virologic and Immunologic Correlates of Breast Milk Acquired Infections in Very Low Birth Weight (VLBW) Infants in a Newborn Intensive Care Unit (NICU) Setting“. Viruses 13, Nr. 10 (22.09.2021): 1897. http://dx.doi.org/10.3390/v13101897.
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Cytomegalovirus (CMV) infections acquired by very-low-birthweight (VLBW) infants are incompletely characterized. To examine CMV transmission in VLBW infants, we evaluated maternal DNAlactia, infant DNAemia, and presence of clinical disease in a blinded study in VLBW infants in our newborn intensive care unit (NICU). To examine these issues, 200 VLBW infants were enrolled in a surveillance study, with weekly breast milk and infant whole blood samples collected, as available. Virologic (breast milk and infant whole blood real time PCR) and immunologic (IgG, IgM, and IgG avidity) correlates were evaluated. A chart review examined whether infants had symptoms compatible with CMV disease. DNAlactia was identified in 65/150 (43%) of lactating mothers. Nine CMV infections were identified in 9/75 CMV-exposed infants (12% of exposed infants). A higher median breast milk viral load (DNAlactia) correlated with an increased likelihood of DNAemia (p = 0.05). Despite potential symptoms compatible with CMV infection, clinicians had not considered the diagnosis of CMV in 6/9 cases (66%). All of these infants had chronic lung disease at discharge. There was no correlation between IgG antibody titer or IgG avidity index and the likelihood of transmission or CMV disease. In conclusion, in VLBW infants receiving milk from seroposi-tive mothers, CMV infections are commonly acquired, and are frequently unrecognized. Future studies are needed to determine whether routine surveillance for CMV of either breast milk or infant plasma is beneficial in preventing or recognizing infection.
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Shodikin, Muhammad Ali, Inke Kusumastuti und Wahidah Nur Indasyah. „The Correlation Between Human Immunodeficiency Virus (HIV) Infections in Pregnancy and Low Birth Weight Infants“. Journal of Health Sciences 14, Nr. 3 (29.08.2021): 209–13. http://dx.doi.org/10.33086/jhs.v14i3.2186.
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Background: The prevalence of Human Immunodeficiency Virus (HIV) infection in pregnancy were increase in developing countries. The existence of infection interferes with the absorption of nutrients due to accumulation of inflammatory cells in the placenta can cause the infant born with low birth weight.
Objective: The purpose of this study was to determine the correlation of HIV infections in pregnancy and low birth weight infant.
Methods: This research used an observational analytic design with a retrospective approach. The samples were positive and negative HIV mother with their infants that hospitalized at dr. Soebandi Hospital, Jember, from August 2014 - July 2017. The data were analysed by Fisher's Exact.
Results: This study was found 52 positive HIV mother with their infants and 52 negative HIV mother with their infants. Nine from 52 infants (17.3%) who born from positive HIV mother were low birth weight. Only 3 from 52 infants (5.8%) who born from negative HIV mother were low birth weight. Data analysis using Fisher’s Exact was obtained p value = 0.06.
Conclusion: There was no significant correlation of HIV infections in pregnancy and low birth weight infant.
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NORBERG, SARAH, CATHERINE STANTON, R. PAUL ROSS, COLIN HILL, GERALD F. FITZGERALD und PAUL D. COTTER. „Cronobacter spp. in Powdered Infant Formula“. Journal of Food Protection 75, Nr. 3 (01.03.2012): 607–20. http://dx.doi.org/10.4315/0362-028x.jfp-11-285.
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Cronobacter species are opportunistic pathogens, and a mortality rate of 40 to 80% is associated with infections. This pathogen can cause a range of serious diseases such as meningitis, septicemia, necrotizing enterocolitis, and brain abscesses and has been responsible for a variety of sequelae such as quadriplegia. Although Cronobacter can cause disease in both adults and infants, infant infections associated with powdered formula are the focus of this review. Since the first reported Cronobacter infection outbreak in 1958, powdered infant formula has been identified as a major source of these outbreaks, resulting in many recalls of powdered infant formula worldwide. This contamination has created an immense problem for the powdered infant formula industry. In this review, we discuss the taxonomy of Cronobacter species, the natural habitat of Cronobacter and its presence in foods, the physiology, pathogenicity, and virulence of Cronobacter species, and available detection methods. We also discuss reported cases of Cronobacter infection linked to powdered infant formula consumption and then focus specifically on the official World Health Organization guidelines for preparation of powdered infant formula.
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Belnoue, Elodie, Paola Fontannaz-Bozzotti, Stéphane Grillet, Paul-Henri Lambert und Claire-Anne Siegrist. „Protracted Course of Lymphocytic Choriomeningitis Virus WE Infection in Early Life: Induction but Limited Expansion of CD8+ Effector T Cells and Absence of Memory CD8+ T Cells“. Journal of Virology 81, Nr. 14 (09.05.2007): 7338–50. http://dx.doi.org/10.1128/jvi.00062-07.
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ABSTRACT Viral infections in human infants frequently follow a protracted course, with higher viral loads and delayed viral clearance compared to viral infections in older children. To identify the mechanisms responsible for this protracted pattern of infection, we developed an infant infection murine model using the well-characterized lymphocytic choriomeningitis virus (LCMV) WE strain in 2-week-old BALB/c mice. In contrast to adult mice, in which viral clearance occurred as expected 8 days after infection, LCMV titers persisted for several weeks after infection of infant mice. LCMV-specific effector CD8+ T cells were elicited in infant mice and fully functional on day 7 but rapidly waned and could not be recovered from day 12 onwards. We show here that this results from the failure of LCMV-specific CD8+ T cells to expand and the absence of protective LCMV-specific memory CD8+ T cells. Under these early life conditions, viral control and clearance are eventually achieved only through LCMV-specific B cells that contribute to protect infant mice from early death or chronic infection.
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Tarca, Elena, Simona Gavrilescu, Laura Florescu, Alina Mariela Murgu, Monica Ungureanu, Vasile Valeriu Lupu und Dana Elena Mindru. „INFECTIONS AND PREMATURITY, IMPORTANT RISK FACTORS FOR NEONATAL MORBIDITY AND MORTALITY“. Romanian Journal of Infectious Diseases 19, Nr. 4 (31.12.2016): 222–25. http://dx.doi.org/10.37897/rjid.2016.4.2.
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Infant mortality is a major problem in developing countries and, unfortunately, this is the case of our country as well, given that Romania ranks first in the European Union in this respect, with an infant mortality rate of 9 ‰, compared to an average of roughly 4 ‰. Worldwide, over 15 million babies are born prematurely each year and, out of these, more than a million die due to prematurity and infections, which are the main risk factors for neonatal mortality. The risk of infection is several times higher in preterm newborns than in full-term newborns – about 80% of neonatal infections occur in premature infants. A significant proportion of the survivors of prematurity will have important neurological sequelae because of neonatal infections as well as of intracerebral bleeding or hypoxia at birth. Continuing medical education in both the general population and the medical sector is crucial in preventing premature births and neonatal infections and, consequently, in decreasing infant morbidity and mortality rates in our country.
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Jason, Janine M. „Infectious Disease-Related Deaths of Low Birth Weight Infants, United States, 1968 to 1982“. Pediatrics 84, Nr. 2 (01.08.1989): 296–303. http://dx.doi.org/10.1542/peds.84.2.296.
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Infant mortality rates in the United States are higher than in any other developed country. Low birth weight (LBW) is the primary determinant of infant mortality. Despite city, state, and federal programs to prevent LBW, decreases in infant mortality in the 1980s appear to be largely secondary to improved survival of LBW infants rather than to a decline in the rate of LBW births. Because prevention of mortality due to infectious disease is feasible, it was of interest to examine the role of infectious diseases in LBW infant mortality. US vital statistics mortality data for 1968 through 1982 were analyzed in terms of LBW infant mortality associated with infectious and noninfectious diseases. These analyses indicated that the rates of infectious disease-associated early neonatal and postneonatal LBW mortality increased during this time; late neonatal rates did not decline appreciably. Infectious diseases were associated with 4% of all LBW infant deaths in 1968; this had increased to 10% by 1982. Although LBW infant mortality rates associated with noninfectious diseases did not differ for white and black populations, infectious disease-associated mortality rates were consistently higher for blacks than whites in both metropolitan and nonmetropolitan areas. Chorioamnionitis was involved in 28% of infectious disease-associated early neonatal LBW deaths. Sepsis was an increasingly listed cause of death in all infant age periods, whereas respiratory tract infections were decreasingly listed. Necrotizing enterocolitis increased as a cause of late neonatal mortality. These data suggest that infectious diseases are an increasing cause of LBW infant mortality and these deaths occur more frequently in the black population targeted by prevention programs. More research concerning specific causes and prevention of infections in the LBW infant may help reduce US infant mortality.
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Wang, Wei-Hao, Fang-Yu Chiu, Tzu-Tung Kuo und Yu-Hsuan Joni Shao. „Maternal Prenatal Infections and Biliary Atresia in Offspring“. JAMA Network Open 7, Nr. 1 (03.01.2024): e2350044. http://dx.doi.org/10.1001/jamanetworkopen.2023.50044.
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ImportanceInvestigations into the association of antepartum maternal infections with the pathogenesis of biliary atresia (BA) in human offspring are insufficient.ObjectiveTo examine the association between prenatal infections in mothers and the development of BA in their offspring.Design, Setting, and ParticipantsThis population-based case-control study obtained administrative data from the Taiwan National Health Insurance Research Database with linkage to the Taiwan Maternal and Child Health Database, capturing demographic and medical information on nearly all 23 million of the Taiwan population. The cohort comprised 2 905 978 singleton live births among mother-infant dyads between January 1, 2004, and December 31, 2020, in Taiwan. The case group of infants with BA was identified from use of International Classification of Diseases diagnostic codes for BA and subsequent Kasai procedure or liver transplant. The control group was randomly selected from infants without BA, representing approximately 1 in 1000 study population. Data analyses were performed from May 1 to October 31, 2023.ExposurePrenatal maternal infections, including intestinal infection, influenza, upper airway infection, pneumonia, soft-tissue infection, and genitourinary tract infection.Main Outcomes and MeasuresThe main outcome was exposure to prenatal maternal infections. Inverse probability weighting analysis was performed by building a logistic regression model to estimate the probability of the exposure observed for a particular infant and using the estimated probability as a weight in subsequent analyses. The weighted odds ratio (OR) estimated by logistic regressions was then used to assess the risk of BA in offspring after prenatal maternal infections.ResultsAmong the mother-infant dyads included, 447 infants with BA were cases (232 females [51.9%]) and 2912 infants without BA were controls (1514 males [52.0%]). The mean (SD) maternal age at childbirth was 30.7 (4.9) years. Offspring exposed to prenatal intestinal infection (weighted OR, 1.46; 95% CI, 1.17-1.82) and genitourinary tract infection (weighted OR, 1.22; 95% CI, 1.05-1.41) in mothers exhibited a significantly higher risk of BA. Furthermore, maternal intestinal infection (weighted OR, 6.05; 95% CI, 3.80-9.63) and genitourinary tract infection (weighted OR, 1.55; 95% CI, 1.13-2.11) that occurred during the third trimester were associated with an increased risk of BA in offspring.Conclusions and RelevanceResults of this case-control study indicate an association between prenatal intestinal infection and genitourinary tract infection in mothers and BA occurrence in their offspring. Further studies are warranted to explore the underlying mechanisms of this association.
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Nampijja, Margaret, Barbara Apule, Swaib Lule, Hellen Akurut, Lawrence Muhangi, Emily L. Webb, Charlie Lewis, Alison M. Elliott und Katie J. Alcock. „Effects of Maternal Worm Infections and Anthelminthic Treatment during Pregnancy on Infant Motor and Neurocognitive Functioning“. Journal of the International Neuropsychological Society 18, Nr. 6 (November 2012): 1019–30. http://dx.doi.org/10.1017/s1355617712000768.
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AbstractWe tested the hypothesis that maternal worm infections in pregnancy affect infant motor and neurocognitive development, and that anthelminthic treatment during pregnancy can reverse these effects. We used measures which examine infant motor, cognitive and executive function, including inhibition. We assessed 983 Ugandan infants aged 15 months, using locally appropriate measures within the Entebbe Mother and Baby Study, a trial of anthelminthic treatment during pregnancy. Key exposures were maternal worm infections and anthelminthic treatment during pregnancy. Effects of other health and social factors were controlled for statistically. Of the five major worm species found in the pregnant women, two had influences on the developmental measures: Maternal Mansonella perstans and Strongyloides stercoralis infections showed negative associations with the A-not B-task, and Language, respectively. Performance on other psychomotor and cognitive measures was associated with illnesses during infancy and infants’ behavior during assessment, but not with maternal worm infections. There were no positive effects of maternal anthelminthic treatment on infant abilities. Mansonella perstans and Strongyloides stercoralis infection during pregnancy seem associated with impaired early executive function and language, respectively, but single-dose anthelminthic treatment during pregnancy was not beneficial. The biological mechanisms that could underlie these neurocognitive effects are discussed. (JINS, 2012, 18, 1019–1030)
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Victora, C. G., P. G. Smith, J. P. Vaughan, L. C. Nobre, C. Lombardi, A. M. B. Teixeira, S. M. Fuchs, L. B. Moreira, L. P. Gigante und F. C. Barros. „Influence of Birth Weight on Mortality From Infectious Diseases: A Case-Control Study“. Pediatrics 81, Nr. 6 (01.06.1988): 807–11. http://dx.doi.org/10.1542/peds.81.6.807.
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The association between birth weight and infant mortality from infectious diseases was investigated in a population-based case-control study in two urban areas in southern Brazil. All deaths of children, seven to 364 days of age, occurring in a year were studied and the parents of the 357 infants dying of an infectious cause were interviewed, as were the parents of two neighborhood control infants for each case. Low birth weight infants (<2,500 g) were found, after allowing for confounding factors, to be 2.3 (90% confidence interval = 1.6 to 3.4) times more likely to die of an infection than those of higher birth weight. The odds ratios were 2.0 (1.1 to 3.6) for deaths due to diarrhea, 1.9 (1.0 to 3.6) for respiratory infections, and 5.0 (1.3 to 18.6) for other infections. These estimates of the risks associated with low birth weight are considerably lower than those from studies in developed countries.
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Science, Michelle, Sarah Khan, Callum Arnold, Pablo J. Sanchez, Kyong-soon Lee, Fabiana Bacchini, Judith Hawes, Dominik Mertz, Salhab el Helou und David Kaufman. „1200. Parent Perspectives on Infection Prevention and Control in the NICU“. Open Forum Infectious Diseases 6, Supplement_2 (Oktober 2019): S431. http://dx.doi.org/10.1093/ofid/ofz360.1063.
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Abstract Background Infants admitted to the neonatal intensive care unit (NICU) are at high risk for healthcare-associated infections (HAIs) due to their immature immune systems and need for invasive devices. Parents have frequent contact with their infants and present an opportunity for prevention practices. The objective of this study was to evaluate parental opinions related to infection prevention and control (IPAC) in the NICU. Methods An online survey was sent to a network of 2,000 parents from the Canadian Premature Babies Foundation. The survey included questions about patient-centered outcomes, IPAC practices experienced during their infants’ NICU admission, and specifically, opinions regarding nonsterile glove use by both healthcare workers (HCWs) and parents. Results A total of 72 parents responded to the survey. The majority were parents of infants born at less than 37 weeks (94%) and had been admitted to an NICU after 2010 (89%). When asked about preventing infections in the NICU, 82% of parents indicated they had been given information on how the NICU prevents infection and 96% had been told how they can prevent infection in their infant (Table 1). The most common information was related to hand hygiene (96%) and what to do if they were unwell (89%). Opportunities for improvement included being bare below the elbow, nail care, and feeding human milk. With respect to IPAC outcomes of interest, 96% agreed that it was important to study interventions to reduce bloodstream infections (BSIs). Other outcomes of interest (Table 2) included necrotizing enterocolitis (72%), antibiotic-resistant organism acquisition (69%), and length of stay (67%). With respect to glove use, 89% of parents felt that it was acceptable for HCWs to wear gloves when caring for their infant. Only 37% of parents indicated that they would want to wear gloves if HCWs were wearing gloves, but 47% would consider wearing gloves if there was evidence that it reduced infection in their infant. Conclusion Reducing infections, specifically BSIs, in infants admitted to the NICU is an outcome of interest for parents. Nonsterile gloving by HCWs is considered an acceptable strategy by parents to reduce infections. Missed opportunities exist for the education of parents in the NICU on IPAC practices. Disclosures All authors: No reported disclosures.
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Hume-Nixon, Maeve, Tupou Ratu, Stephanie Clark, Cattram Duong Nguyen, Eleanor F. G. Neal, Casey L. Pell, Kathryn Bright et al. „Prevention of young infant infections using oral azithromycin in labour in Fiji (Bulabula MaPei): study protocol of a randomised control trial“. BMJ Open 12, Nr. 12 (Dezember 2022): e061157. http://dx.doi.org/10.1136/bmjopen-2022-061157.
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IntroductionInfections are a leading cause of neonatal mortality globally and can be transmitted from mother-to-child vertically or horizontally. Fiji has higher rates of serious neonatal infections and infant skin and soft tissue infections (SSTIs) than high-income countries. Research from the Gambia found that a single dose of oral azithromycin in labour decreased bacterial carriage and infections in mothers and infants, particularly infant skin infections. The Bulabula MaPei clinical trial evaluates the safety and efficacy of a single dose of azithromycin in labour in reducing the incidence of maternal and infant SSTIs and other infections and the impact on bacterial carriage. It will also describe the effect of azithromycin on antimicrobial (AMR) resistance, the maternal and infant microbiome, and infant dysbiosis.Methods and analysisWe are conducting a blinded, placebo-controlled randomised clinical trial administering 2 g of oral azithromycin, or placebo, given to healthy, pregnant women (≥18 years) in labour in Suva, Fiji. The primary outcome is the cumulative incidence of SSTIs in infants by 3 months of age. Secondary outcomes include the incidence of other infant and maternal infections, and safety and tolerability of azithromycin in mother and infant. Following informed consent, 2110 pregnant women will be randomised in a 1:1 ratio, with all study staff and participants masked to group allocation. Mother/infant pairs will be followed up for 12 months over six visits collecting clinical data on infections, antimicrobial use, safety and anthropometrics, in addition to nasopharyngeal, oropharyngeal, rectovaginal and vaginal swabs, maternal breastmilk and infant stool samples, in order to compare bacterial carriage, AMR rates and microbiome. Recruitment for Bulabula MaPei started in June 2019.Ethics and disseminationThis trial was approved and is being conducted according to the protocol approved by The Royal Children’s Hospital Human Research Ethics Committee, Australia, and the Fiji National Health Research and Ethics Review Committee. The findings of this study will be disseminated in peer-reviewed journals and presented at conferences.Trial registration numberNCT03925480.
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Yasui, Hisako, Junko Kiyoshima und Tetsuji Hori. „Reduction of Influenza Virus Titer and Protection against Influenza Virus Infection in Infant Mice Fed Lactobacillus casei Shirota“. Clinical Diagnostic Laboratory Immunology 11, Nr. 4 (Juli 2004): 675–79. http://dx.doi.org/10.1128/cdli.11.4.675-679.2004.
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ABSTRACT We investigated whether oral administration of Lactobacillus casei strain Shirota to neonatal and infant mice ameliorates influenza virus (IFV) infection in the upper respiratory tract and protects against influenza infection. In a model of upper respiratory IFV infection, the titer of virus in the nasal washings of infant mice administered L. casei Shirota (L. casei Shirota group) was significantly (P < 0.05) lower than that in infant mice administered saline (control group) (102.48 ± 100.31 and 102.78 ± 100.4, respectively). Further, the survival rate of the L. casei Shirota group was significantly (P < 0.05) higher than that of the control group (14.3 versus 40.0%). One day after infection, pulmonary NK cell activity and interleukin-12 production by mediastinal lymph node cells of mice in the L. casei Shirota group were significantly greater than those of mice in the control group. These findings suggest that oral administration of L. casei Shirota activates the immature immune system of neonatal and infant mice and protects against IFV infection. Therefore, oral administration of L. casei Shirota may accelerate the innate immune response of the respiratory tract and protect against various respiratory infections in neonates, infants, and children, a high risk group for viral and bacterial infections.
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DOBBS, KATHERINE R., und ARLENE E. DENT. „Plasmodium malaria and antimalarial antibodies in the first year of life“. Parasitology 143, Nr. 2 (08.01.2016): 129–38. http://dx.doi.org/10.1017/s0031182015001626.
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SUMMARYMalaria is one of the most serious infectious diseases with most of the severe disease caused byPlasmodium falciparum(Pf). Naturally acquired immunity develops over time after repeated infections and the development of antimalarial antibodies is thought to play a crucial role. Neonates and young infants are relatively protected from symptomatic malaria through mechanisms that are poorly understood. The prevailing paradigm is that maternal antimalarial antibodies transferred to the fetus in the last trimester of pregnancy protect the infant from early infections. These antimalarial antibodies wane by approximately 6 months of age leaving the infant vulnerable to malaria, however direct evidence supporting this epidemiologically based paradigm is lacking. As infants are the target population for future malaria vaccines, understanding how they begin to develop immunity to malaria and the gaps in their responses is key. This review summarizes the antimalarial antibody responses detected in infants and how they change over time. We focus primarily on Pf antibody responses and will briefly mentionPlasmodium vivaxresponses in infants.
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Jorgensen, S. C. J., A. Hernandez, D. B. Fell, P. C. Austin, R. D'Souza, A. Guttmann, K. A. Brown et al. „Maternal mRNA COVID-19 Vaccination During Pregnancy and Delta or Omicron Infection or Hospital Admission in Infants: Test Negative Design Study“. Obstetric Anesthesia Digest 43, Nr. 4 (20.11.2023): 199. http://dx.doi.org/10.1097/01.aoa.0000990444.65560.47.
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(BMJ. 2023;380:e074035) Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) rates are higher in infants than in older children. Passive immunity has been shown to help prevent other infections, such as pertussis, in infants through the transfer of maternal antibodies following vaccination during pregnancy. SARS-CoV-2 antibodies are found to be present in breastmilk, umbilical cord blood, and infant serum specimens following maternal vaccination during pregnancy and infection, and emerging research suggests maternal COVID-19 vaccination reduces infant infection and hospital admission rates. This study aimed to determine whether maternal vaccination during pregnancy with 2 primary doses or 2 primary doses plus booster of the mRNA COVID-19 vaccine series reduces the infection of omicron and delta SARS-CoV-2 and hospital admission of infants within 6 months following delivery.
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REGAN, A. K., H. C. MOORE, S. G. SULLIVAN, N. DE KLERK und P. V. EFFLER. „Epidemiology of seasonal influenza infection in pregnant women and its impact on birth outcomes“. Epidemiology and Infection 145, Nr. 14 (11.09.2017): 2930–39. http://dx.doi.org/10.1017/s0950268817001972.
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SUMMARYSeasonal influenza can cause significant morbidity in pregnant women. Much of the existing epidemiological evidence on influenza during pregnancy has focused on the 2009 A/H1N1 pandemic. To measure the epidemiological characteristics of seasonal influenza infection among pregnant women and the impact on infant health, a cohort of 86 779 pregnancies during the influenza season (2012–2014) was established using probabilistic linkage of notifiable infectious disease, hospital admission, and birth information. A total of 192 laboratory-confirmed influenza infections were identified (2·2 per 1000 pregnancies), 14·6% of which were admitted to hospital. There was no difference in the proportion of infections admitted to hospital by trimester or subtype of infection. Influenza B infections were more likely to occur in second trimester compared with influenza A/H3N2 and influenza A/H1N1 infections (41·3%, 23·6%, and 33·3%, respectively), and on average, infants born to women with influenza B during pregnancy had 4·0% (95% CI 0·3–7·6%) lower birth weight relative to optimal compared with infants born to uninfected women (P = 0·03). Results from this linked population-based study suggest that there are differences in maternal infection by virus type and subtype and support the provision of seasonal influenza vaccine to pregnant women.
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Kato, Hideo, Mao Hagihara, Hiroko Matsuda und Takuya Iwamoto. „Gentamicin Pharmacokinetics and Optimal Dosage in Infant Patients: A Case Report and Literature Review“. International Journal of Environmental Research and Public Health 19, Nr. 22 (21.11.2022): 15360. http://dx.doi.org/10.3390/ijerph192215360.
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Gentamicin is an aminoglycoside antibiotic that is mostly used for the pediatric population. While the pediatric population is classified into neonates, infants, children, and adolescents based on developmental or maturational changes, infants are often overlooked in research. Three infant cases receiving gentamicin are presented to illustrate the pharmacokinetics and optimum dosage of gentamicin. Three infant patients received gentamicin (5.6–7.5 mg/kg/day) for urinary tract infections (UTIs) or bacteremia caused by Enterobacter aerogenes. The trough (Cmin) and peak (Cpeak) concentrations of gentamicin were 0.2–1.8 and 8.9 mg/L, respectively. The Cmin of a patient receiving gentamicin at 9.0 mg/kg/day was 3.3 mg/L, and the patient showed a decrease in urinary volume. The other two patients fully recovered from the infection and did not experience any adverse events. Additionally, we reviewed three studies regarding infant patients receiving gentamicin. The studies used gentamicin therapy for Gram-negative pathogen infections and UTIs caused by Escherichia coli and Enterococcus faecalis. The Cmin and Cpeak of patients receiving gentamicin at 2.2–7.5 mg/kg/day were 0.58–2.15 mg/kg and 4.67–8.88 mg/L, respectively. All patients were cured without any adverse events. Gentamicin dosages below 7.5 mg/kg/day may be effective and safe for use in infant patients. However, the optimal dosing regimen of gentamicin in infant patients is controversial, and limited data are available.
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Wongsawat, Jurai, Somsak Thamthitiwat, Victoria J. Hicks, Sumonmal Uttayamakul, Phanthaneeya Teepruksa, Pongpun Sawatwong, Beth Skaggs et al. „Characteristics, risk factors, and outcomes related to Zika virus infection during pregnancy in Northeastern Thailand: A prospective pregnancy cohort study, 2018–2020“. PLOS Neglected Tropical Diseases 18, Nr. 5 (17.05.2024): e0012176. http://dx.doi.org/10.1371/journal.pntd.0012176.
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Background In response to the 2015–2016 Zika virus (ZIKV) outbreak and the causal relationship established between maternal ZIKV infection and adverse infant outcomes, we conducted a cohort study to estimate the incidence of ZIKV infection in pregnancy and assess its impacts in women and infants. Methodology/Principal findings From May 2018-January 2020, we prospectively followed pregnant women recruited from 134 participating hospitals in two non-adjacent provinces in northeastern Thailand. We collected demographic, clinical, and epidemiologic data and blood and urine at routine antenatal care visits until delivery. ZIKV infections were confirmed by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). Specimens with confirmed ZIKV underwent whole genome sequencing. Among 3,312 women enrolled, 12 (0.36%) had ZIKV infections, of which two (17%) were detected at enrollment. Ten (83%, 3 in 2nd and 7 in 3rd trimester) ZIKV infections were detected during study follow-up, resulting in an infection rate of 0.15 per 1,000 person-weeks (95% CI: 0.07–0.28). The majority (11/12, 91.7%) of infections occurred in one province. Persistent ZIKV viremia (42 days) was found in only one woman. Six women with confirmed ZIKV infections were asymptomatic until delivery. Sequencing of 8 ZIKV isolates revealed all were of Asian lineage. All 12 ZIKV infected women gave birth to live, full-term infants; the only observed adverse birth outcome was low birth weight in one (8%) infant. Pregnancies in 3,300 ZIKV-rRT-PCR-negative women were complicated by 101 (3%) fetal deaths, of which 67 (66%) had miscarriages and 34 (34%) had stillbirths. There were no differences between adverse fetal or birth outcomes of live infants born to ZIKV-rRT-PCR-positive mothers compared to live infants born to ZIKV-rRT-PCR-negative mothers. Conclusions/Significance Confirmed ZIKV infections occurred infrequently in this large pregnancy cohort and observed adverse maternal and birth outcomes did not differ between mothers with and without confirmed infections.
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Thapa, Puspa, Rebecca S. Guyer und Donna L. Farber. „Infant T cells exhibit increased TCR signaling and proliferation to respiratory infection“. Journal of Immunology 202, Nr. 1_Supplement (01.05.2019): 122.13. http://dx.doi.org/10.4049/jimmunol.202.supp.122.13.
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Abstract Infants are highly susceptible to respiratory infections and frequently experience recurrent episodes. Our previous study demonstrated that tissue resident memory T cells (TRM), which are critical in mediating long-term protection against pathogens, are reduced in infant mice compared to adult mice after influenza infection. However, the underlying mechanisms for reduced TRM generation in infants is still unknown. Our preliminary data show that infant T cells have enhanced TCR sensitivity leading to increased activation compared to adult T cells and thus are biased towards effector differentiation at the expense of memory formation. We show that infant OVA-specific (OTII) T cells exhibit lower T cell activation threshold for proliferation and enhanced sensitivity for low does of antigen. Infant T cells express higher levels of CD69 and CD25 with a greater induction of Nur77, a direct indicator of TCR signal strength, at peptide doses that fail to fully activate adult T cells. Co-transfer of infant and adult OTII T cells into a congenic host resulted in infant T cells dominating the effector response in the lungs (at a ratio of 3:1) after primary influenza challenge. At the peak of infection, infant effector T cells also expressed lower levels of TCF1 and Bcl-2, indicating transcriptional bias for terminal effector differentiation with reduced survival. Moreover, infant derived effector and memory T cells express lower levels of CD5, suggesting enhanced survival of lower affinity T cells after influenza infection. Taken together, these results show that enhanced sensitivity for antigenic stimulation promotes cell intrinsic mechanisms that govern decreased potential of infants to form durable and functional lung TRM.
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Tan, Anna Soleil Cheshia. „Outcomes of HIV-Exposed Infants enrolled in the Prevention of Mother to Child Transmission of HIV (PMTCT) Program in Philippine General Hospital: An 8-year Retrospective Study“. Pediatric Infectious Disease Society of the Philippines Journal 22, Nr. 1 (21.05.2021): 51–62. http://dx.doi.org/10.56964/pidspj2021220107.
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Background: Our country has the fastest growing number of HIV cases in the Asia-Pacific region with a 203% increase from 2010 to 2018. MTCT represents 6% of infections in children and interventions such as the PMTCT program are essential to help reduce new infant infections. Objective: To determine the outcomes of HIV-exposed infants born in PGH from 2010 to 2018 enrolled in the PMTCT program. To analyze the association of maternal and neonatal clinicodemographic factors to MTCT of HIV. Methods: A retrospective cohort study using data collected from medical records of HIV exposed infants enrolled in the program. Results: Out of 117 mother-infant pairs, only 70 met the eligibility criteria. Maternal factors showed that majority have: timely antenatal visit (56/70), maternal HIV diagnosis (70/70) and ART initiation (67/70) prior to delivery, triple lifelong maternal ART (69/70), CD4 >200 prior to delivery (52/70) and cesarean delivery (67/70). Amongst the infant factors-early infant prophylaxis (60/62), >4weeks prophylaxis duration (62/70) and replacement feeding (62/70) were noted in the majority. 2/70 infants were HIV positive. Mortality rate was 1.4% and 50% for HIV infected infants. Overall LTFU rate was 33.3%. Logistic regression showed that maternal co-infection with Hepatitis B(p=0.0275) was a possible determinant of MTCT. Infant HIV prophylaxis duration of >4 weeks had higher survival proportion(p=.0001). Conclusion: The HIV MTCT rate was 2.86% upon implementation of our PMTCT program, meeting the <5% goal of WHO, suggesting that the program was an effective health intervention strategy. The high LTFU rate though should be considered in the evaluation of the program effectiveness.
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Zens, Kyra D., Jun Kui Chen, Rebecca S. Guyer, Felix L. Wu, Filip Cvetkovski, Michelle Miron und Donna L. Farber. „Reduced generation of lung tissue–resident memory T cells during infancy“. Journal of Experimental Medicine 214, Nr. 10 (30.08.2017): 2915–32. http://dx.doi.org/10.1084/jem.20170521.
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Infants suffer disproportionately from respiratory infections and generate reduced vaccine responses compared with adults, although the underlying mechanisms remain unclear. In adult mice, lung-localized, tissue-resident memory T cells (TRMs) mediate optimal protection to respiratory pathogens, and we hypothesized that reduced protection in infancy could be due to impaired establishment of lung TRM. Using an infant mouse model, we demonstrate generation of lung-homing, virus-specific T effectors after influenza infection or live-attenuated vaccination, similar to adults. However, infection during infancy generated markedly fewer lung TRMs, and heterosubtypic protection was reduced compared with adults. Impaired TRM establishment was infant–T cell intrinsic, and infant effectors displayed distinct transcriptional profiles enriched for T-bet–regulated genes. Notably, mouse and human infant T cells exhibited increased T-bet expression after activation, and reduction of T-bet levels in infant mice enhanced lung TRM establishment. Our findings reveal that infant T cells are intrinsically programmed for short-term responses, and targeting key regulators could promote long-term, tissue-targeted protection at this critical life stage.
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Kryvopustov, S. P. „Lactobacillus reuteri DSM 17938 and vitamin D3 in common clinical problems of infants“. Modern pediatrics. Ukraine, Nr. 1(113) (19.02.2021): 68–72. http://dx.doi.org/10.15574/sp.2021.113.68.
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Purpose — to demonstrate the clinical significance of Lactobacillus reuteri DSM 17938 and vitamin D3 in common clinical problems in infants. Materials and methods. Clinical cases in pediatrics of infancy in children with infant colic (G4), infant regurgitation (G1), functional constipation (G7) are presented. Some international recommendations regarding a preventive dose of vitamin D in the first year of a child' life are considered. Results. The behavior of an infant is often a concern for parents and is a reason for seeking medical help. In particular, it has been shown when acute crying of a child is associated with threatening conditions. The prevalence of functional gastrointestinal disorders and the importance of using the Rome IV criteria in practice are emphasized. Clinical examples of infant colic (G4), infant regurgitation (G1), functional constipation (G7) demonstrated the management of patients with the importance of counseling, showing the evidence base for the use of Lactobacillus reuteri DSM 17938 and vitamin D3. Works on the importance of vitamin D for the prevention of respiratory infections and its dosage are presented. Conclusions. For children in the first year of life with infant colic (G4), infant regurgitation (G1), functional constipation (G7), counseling is important, as well as the use of, in particular, Lactobacillus reuteri DSM 17938. Additional benefits are provided by the combined use of Lactobacillus reuteri DSM 17938 with vitamin D3, which is also discussed for the prevention of respiratory infections. Provided international recommendations for a daily preventive dose of 400 IU of vitamin D for infants. No conflict of interest was declared by the author. Key words: vitamin D, infants, respiratory infections, functional gastrointestinal disorders, Lactobacillus reuteri DSM 17938.
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Auger, Nathalie, Caroline Quach, Jessica Healy-Profitós, Anne-Marie Lowe und Laura Arbour. „Congenital microcephaly in Quebec: baseline prevalence, risk factors and outcomes in a large cohort of neonates“. Archives of Disease in Childhood - Fetal and Neonatal Edition 103, Nr. 2 (04.07.2017): F167—F172. http://dx.doi.org/10.1136/archdischild-2016-311199.
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ObjectiveWe assessed baseline prevalence, risk factors and outcomes of microcephaly in a large population of neonates.DesignRetrospective cohort study.SettingAll hospitals in the province of Quebec, Canada.Participants794 microcephalic and 1 944 010 non-microcephalic infants born between 1989 and 2012.Main outcome measuresBaseline prevalence of microcephaly and occurrence of other congenital anomalies. We estimated the association of (1) pregnancy risk factors including TORCH infections (toxoplasmosis, rubella, cytomegalovirus, herpes, other), exposure to teratogens, diabetes and maternal congenital anomalies with risk of microcephaly, and (2) microcephaly with risk of infant mortality and severe morbidity, adjusted for maternal characteristics.ResultsThe overall prevalence of microcephaly was 4.1 per 10 000, ranging between 3.0 and 5.3 per 10 000 over time. Only 37% of microcephalic infants presented with other congenital anomalies. Maternal infection during pregnancy was the strongest risk factor, with 32 times the risk of microcephaly (prevalence ratio 32.38; 95% CI 22.42 to 46.75) compared with no infection. Exposure to teratogens was the next most important risk factor, with three times greater risk (prevalence ratio 3.10; 95% CI 2.37 to 4.07). Microcephaly was associated with 20 times the risk of infant mortality compared with no microcephaly (prevalence ratio 20.52; 95% CI 15.57 to 27.04) and significantly greater infant morbidity.ConclusionsIn Canada, infectious exposure during pregnancy is a strong risk factor for microcephaly, and affected infants are at higher risk of poor birth outcomes. Better monitoring of microcephaly is needed in the event that Zika or other novel viruses affect future risk.
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Ahlfors, Karin, Sten-Anders Ivarsson und Ingrid Bjerre. „Microcephaly and Congenital Cytomegalovirus Infection: A Combined Prospective and Retrospective Study of a Swedish Infant Population“. Pediatrics 78, Nr. 6 (01.12.1986): 1058–63. http://dx.doi.org/10.1542/peds.78.6.1058.
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Microcephaly and its etiology were studied in an unselected Swedish urban infant population. Virtually, all live-born infants (14,724) born between October 1977 and December 1983 in the city of Malmö, Sweden, were included in the study. Special attention was given to the role of congenital infections, particularly to cytomegalovirus infection. The infant population was studied from two points of view. One part of the study was prospective and based on regular cytomegalovirus isolation in urine within the first week of life. About 80% of the newborns were adequately studied by this test. None of 56 infants shown to be cytomegalovirus excreters (congenitally infected) and followed up were born with or developed microcephaly (head circumference smaller than 3 SD below the mean for age and sex) during the first 1 to 7 years of life. However, two of the 56 infants had a head circumference of –2 SD. In the beginning of 1985, an inventory was made of the presence of symptomatic microcephaly in the abovementioned population still living in the city or deceased there. Of about 10,000 such children, 12 were found to have symptomatic microcephaly. By studies of personal, clinical, and laboratory data and by retrospective serologic studies of frozen pre- and postconceptional maternal sera, a possible explanation or a recognized syndrome was obtained in ten of the 12 cases. In one of them, the mother had a primary cytomegalovirus infection, possibly in early pregnancy. Although the infant had symptoms compatible with a congenital infection, no laboratory evidence of transmitted infection was found. In no case were congenital rubella virus or Toxoplasma gondii infections suspected.
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Prasitwattanaseree, Sukon, Marc Lallemant, Dominique Costagliola, Gonzague Jourdain und Jean-Yves Mary. „Influence of Mother and Infant Zidovudine Treatment Duration on the Age at Which HIV Infection Can be Detected by Polymerase Chain Reaction in Infants“. Antiviral Therapy 9, Nr. 2 (Februar 2004): 179–85. http://dx.doi.org/10.1177/135965350400900213.
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Objective To investigate the influence of zidovudine (ZDV) prophylaxis duration in mothers and infants on the age at which infection becomes detectable by DNA polymerase chain reaction (PCR) in non-breastfed infants. Methods Blood samples were collected sequentially from birth to 6 months in a Thailand perinatal HIV prevention trial in which 98 transmissions occurred. The proportions of infections detectable at birth and the Turnbull distributions of age at which infection became detectable after birth were compared according to actual ZDV treatment duration (mothers: no more than 7.5 weeks versus more; infants: 3 days versus at least 4 weeks), provided an adherence greater than 75%. Results Detectable infection at birth was less frequent in children whose mothers received a long treatment as compared to a short treatment (27 vs 50%, P=0.04). When mothers received a long treatment, infant ZDV treatment duration did not influence the distribution of age at which infection became detectable after birth (median 24 days). However, when mothers received a short treatment, this distribution was shifted to the right when infants received a long treatment (median 43 days, P<0.0001), and to the left when infants received a short treatment (median 11 days, P<0.0001). Conclusions When mothers receive a short treatment, the proportion of infections detectable at birth is higher and the time at which infection becomes detectable after birth depends on the infant treatment duration. In the study conditions, a PCR result after 2 months could be used to define infection status.
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Radke, Michael, Jean-Charles Picaud, Andrea Loui, Gilles Cambonie, Dirk Faas, Harry N. Lafeber, Nanda de Groot, Sophie S. Pecquet, Philippe G. Steenhout und Jean-Michel Hascoet. „Starter formula enriched in prebiotics and probiotics ensures normal growth of infants and promotes gut health: a randomized clinical trial“. Pediatric Research 81, Nr. 4 (21.12.2016): 622–31. http://dx.doi.org/10.1038/pr.2016.270.
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Abstract Background: Prebiotics and probiotics exert beneficial effects by modulating gut microbiota and immune system. This study evaluates efficacy and safety of an infant formula containing bovine milk-derived oligosaccharides and Bifidobacterium animalis ssp lactis (B. lactis) (CNCM I-3446) on incidence of diarrhea and febrile infections during the first year of life (primary outcome). Methods: Full-term infants receiving Test or Control (without bovine milk-derived oligosaccharide and B. lactis) formulae were enrolled in a multicenter, randomized, controlled, and double-blind trial with a reference breastfeeding group. . Results: 413 infants were assigned between Test (n = 206) and Control (n = 207) formula. There was no significant difference for diarrhea and febrile infections incidence between groups at 6 (odds ratio (95% confidence interval) = 0.56 (0.26–1.15), P = 0.096) and 12 mo (odds ratio = 0.66 (0.38–1.14), P = 0.119). Test formula was well tolerated, anthropometrics parameters were not significantly different between groups and aligned with WHO growth standards up to 12 mo. Data from test group showed that gut microbiota pattern, fecal IgA and stool pH were brought to be closer to those of breastfed infants. Conclusion: An infant formula enriched with bovine milk-derived oligosaccharide and B. lactis supports normal infant growth, is well tolerated and improves intestinal health markers. No differences in diarrhea and febrile infection incidence were found in the population studied.
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Brown, Julia A., Hannah Carrow, Jenny C. Jin, Aparna Ananthanarayanan, Katherine Z. Sanidad, Elizabeth L. Johnson, Jeffrey M. Perlman, Stefan Worgall und Melody Y. Zeng. „The preterm infant microbiome impairs lung immune responses to respiratory syncytial virus infection“. Journal of Immunology 208, Nr. 1_Supplement (01.05.2022): 59.03. http://dx.doi.org/10.4049/jimmunol.208.supp.59.03.
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Abstract The gut microbiome plays a critical role in neonatal immune development; early-life perturbations to the microbiome have been linked to later susceptibility to respiratory conditions, including asthma and chronic obstructive pulmonary disease. Preterm infants are at higher risk for adverse outcomes to respiratory infections such as respiratory syncytial virus (RSV). The microbiome in premature infants is significantly altered, but it remains unclear how this affects lung immune cell development and susceptibility to RSV infection independent of lung immaturity. In this study, we have generated a biorepository of stool specimens from preterm and term infants during the first weeks of life. Metagenomic sequencing studies indicate significant alterations in the gut microbiome between these two groups, including a lack of fiber-fermenting Bacteroides species in preterm infants. Using these stool specimens, we find that the altered gut microbiome in premature infants induces IL-17/neutrophil-biased immune responses but weaker anti-viral interferon responses in the lung, both at steady state and following RSV infection. Mice colonized with preterm infant stool bacteria produced lower levels of neutralizing antibodies against RSV than mice colonized with term infant stool bacteria. Taken together, our findings suggest that the altered gut microbiome in premature infants dysregulates immune cell development in the lung and impairs the infant’s ability to develop long-term immunity against respiratory infections. These findings might be potentially leveraged in the development of gut bacteria-based interventions to improve the development of protective immunity against respiratory viral pathogens in preterm infants. Supported by grants from NIH/NCATS (TL1-TR-002386) and the Biocodex Microbiota Foundation
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EKELUND, K., und H. B. KONRADSEN. „Invasive group B streptococcal disease in infants: a 19-year nationwide study. Serotype distribution, incidence and recurrent infection“. Epidemiology and Infection 132, Nr. 6 (16.11.2004): 1083–90. http://dx.doi.org/10.1017/s0950268804002808.
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During the period 1984–2002, 472 cases of invasive group B streptococcal (GBS) disease in infants aged 0–90 days in Denmark were registered. The overall incidence was 0·4/1000 live births. Most infants (73%) had early-onset GBS infection with 53% registered within the first day. Serotype III predominated (59%) with other serotypes as follows: Ia (16%), Ib (8%), NT (7%), II (6%), other serotypes (5%). Recurrence of GBS infection was registered in six infants, and the interval with no antibiotic therapy varied from 2 to 39 days. The serotypes of the isolates obtained from first and second episodes were identical (serotype III in five, and serotype Ia in one infant). Paired isolates were indistinguishable by PFGE and antibiotic susceptibility testing. Invasive GBS infections in infants are still a problem in Denmark, and recurrent infections are registered in 1% of these infants.
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Aydin Teke, Turkan, Fatma Nur Oz, Ozge Metin, Gulsum Iclal Bayhan, Zeynep Gökce Gayretli Aydin, Melek Oguz und Gonul Tanir. „Chryseobacterium indologenesSepticemia in an Infant“. Case Reports in Infectious Diseases 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/270521.
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Chryseobacterium indologenesis a rare cause of infection in children. The organism causes infections mostly in hospitalised patients with severe underlying diseases. The choice of an effective drug for the treatment of infections due toC. indologenesis difficult as the organism has a limited spectrum of antimicrobial sensitivity. We present a case of nosocomial septicemia caused byC. indologenesin an infant with congenital heart disease who was successfully treated with trimethoprim sulfamethoxazole and also reviewed fourteen additional cases ofC. indologenesinfections reported in the English literature in this report.
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Shaheen, Somia, Faiza Javed, Germaine Neh, Hadia Asif und Kiran Bhat. „Improved outcomes after the introduction of donor breast milk“. Journal of Pediatrics & Neonatal Care 13, Nr. 3 (01.12.2023): 236–37. http://dx.doi.org/10.15406/jpnc.2023.13.00524.
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Premature infants are at considerable risk of increased morbidity and mortality. They have a higher risk of learning disabilities, cerebral palsy, sensory deficits, respiratory illnesses, and gastrointestinal illnesses.1,2 Providing mother's own milk to the preterm infant has nutritional, gastrointestinal, immunological, developmental, and psychological benefits. Breastfed preterm infants have a lower rate of ear infections, respiratory infections, or infection‐related events. They have lower rates of gastrointestinal infections, necrotizing enterocolitis, and mortality. When milk from the mother is not available, human donor milk is an important option, because it maintains many of its health benefits. This article shines light on the improved outcomes of premature infants after the introduction of donor breast milk and also discusses the multiple challenges faced by a level three NICU of a tertiary care hospital during the implementation of Donor Breast Milk program.
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Pastor-Villaescusa, B., J. A. Hurtado, M. Gil-Campos, J. Uberos, J. A. Maldonado-Lobón, M. P. Díaz-Ropero, O. Bañuelos, J. Fonollá und M. Olivares. „Effects of Lactobacillus fermentum CECT5716 Lc40 on infant growth and health: a randomised clinical trial in nursing women“. Beneficial Microbes 11, Nr. 3 (11.05.2020): 235–44. http://dx.doi.org/10.3920/bm2019.0180.
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The breast milk microbiota has been described as a source of bacteria for infant gut colonisation. We studied the effect of Lactobacillus fermentum CECT5716 (Lc40) on growth and infection incidence of the infants, when the probiotic is administrated to the mothers. Moreover, whether such effects might depend on the interaction between the mother or infant microbiota and the probiotic administration. A total of 291 mother-infant pairs were studied for 16 weeks in a randomised double-blinded placebo-controlled multicentre trial. The Lc40 group (n=139) received 1 capsule/day containing 3×109 cfu Lc40; the control group (n=152) received 1 placebo (maltodextrin) capsule/day. A positive and significant correlation of the Staphylococcus load between breast milk and infant faeces was only observed in control group. Additionally, the weight z-score of the infants whose mothers had higher values of Lactobacillus in their breast milk were significantly higher for the Lc40 group. We observed a significant lower incidence of conjunctivitis in the infants whose mothers received Lc40. A higher load of Staphylococcus in infant faeces significantly increased the risk of respiratory infections. Such incidence, under an absent or low Staphylococcus load in the faeces, was significantly 36 times higher in the infants in the control group than in the infants in the Lc40 group. However, the protective effect of Lc40 was gradually reduced as the Staphylococcus load of the milk increased. The administration of Lc40 to nursing women might influence infant growth and health but it seems to depend on its interactions with mother or infant microbiota. Registered in the US Library of Medicine ( www.clinicaltrials.gov ): NCT02203877.
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Blood-Siegfried, Jane, Margaret T. Bowers und Marcia Lorimer. „Is Shock a Key Element in the Pathology of Sudden Infant Death Syndrome (SIDS)?“ Biological Research For Nursing 11, Nr. 2 (28.12.2008): 187–94. http://dx.doi.org/10.1177/1099800408324854.
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In developed countries, sudden infant death syndrome (SIDS) is the most common cause of death for infants between 1 month and 1 year of age. The etiology of SIDS is likely to be multifactorial, and current paradigms often describe three overlapping elements of risk. Those elements are a critical developmental period, a vulnerable infant, and one or more exogenous stressors. In the triple-risk model, SIDS infants are described as having an underlying vulnerability in cardiorespiratory control in the central nervous system during a critical period when autonomic control is developing. This vulnerability might affect the response to exogenous stressors, including prone sleeping position, hypoxia, and increased carbon dioxide. In the common bacterial hypothesis and fatal triangle, the focus is on the stressors. In the first, a combination of common respiratory infections can cause SIDS in an infant during a developmentally vulnerable period. This theory also includes 3 factors of vulnerability: a genetic predisposition, a vulnerable developmental age, and infectious stressors. In the fatal triangle theory, infection, inflammation, and genetics each play a role in triggering a SIDS fatality. From our work in an animal model, we have found that rat pups die from a combination of infectious insults during a critical time of development. This is exacerbated by perinatal nicotine exposure, a condition shown to alter the autonomic response in exposed offspring. We are proposing that shock and cardiovascular collapse is a key element that links these theories.
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Dos Santos Souza, Daniela Cristina, Diego Henrique Ferreira Mussatto, Paula de Almeida Souza Santos da Costa, Ellen Diniz de Menezes, Magno Giovani Zanelatto, Marcelo Padovani de Toledo Moraes, Maria Aparecida Custodio Domingues, Pedro Marciano de Oliveira, Simone Antunes Terra und Elida Paula Benquique Ojopi. „Bronchiolitis in an infant due to influenza A, necropsy findings: a case report“. Brazilian Journal of Case Reports 4, Nr. 4 (21.02.2024): 23–33. http://dx.doi.org/10.52600/2763-583x.bjcr.2024.4.4.23-33.
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The influenza virus is an important cause of respiratory disease in infants and presents challenging differential diagnoses to investigate. This is a case report that involves a necroscopic study of a 2-month-old male infant, without previous comorbidities, with a serological diagnosis of influenza A and histopathological presentation of non-obliterating bronchiolitis. Infants are considered a high-risk group for flu complications due to the immaturity of the immune system and the ability to respond to respiratory infections. Furthermore, the severity of infection in infants may be worsened by the difficulty in quickly considering and treating the symptoms of the disease.
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Ronchi, Andrea, Christopher P. Ouellette, Asuncion Mejías, Douglas Salamon, Amy Leber, Lorenza Pugni, Fabio Mosca und Pablo J. Sánchez. „Detection of cytomegalovirus in saliva from infants undergoing sepsis evaluation in the neonatal intensive care unit: the VIRIoN-C study“. Journal of Perinatal Medicine 47, Nr. 1 (19.12.2018): 90–98. http://dx.doi.org/10.1515/jpm-2018-0021.
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Abstract Objective To determine the frequency of detection of cytomegalovirus (CMV) among infants evaluated for late-onset sepsis in the neonatal intensive care unit (NICU). Methods This study was a prospective cohort study. Results During the 13-month study, 84 infants underwent 116 sepsis evaluations, and CMV DNA was detected in saliva in three (4%) infants (median: gestational age 28 weeks, birth weight 950 g), representing 5% (n=6) of all sepsis evaluations. One infant had CMV DNA detected in saliva in all four sepsis evaluations. Two infants had acquired CMV infection, while the timing of CMV acquisition could not be determined in one infant. Two of the three infants had concomitant Gram-negative bacteremia and urinary tract infections (UTIs), two developed severe bronchopulmonary dysplasia (BPD) and none died. Conclusion Detection of CMV DNA in saliva occurred in 4% of infants and 5% of sepsis evaluations. Persistence of CMV DNA shedding in saliva made attribution of clinical illness difficult to ascertain.
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Kakkar, F., und I. Boucoiran. „The Women and Children’s Infectious Diseases Center: An integrated approach to congenital infectious diseases“. Clinical and Investigative Medicine 41, Nr. 4 (30.01.2019): E211—E212. http://dx.doi.org/10.25011/cim.v41i4.32223.
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Congenital infectious diseases, transmitted during the course of pregnancy, are estimated to affect nearly one in every hundred births worldwide. These infections may be associated with fetal and infant adverse health outcomes, due to congenital malformations caused by in utero transmission of the infectious organism itself (as is the case with cytomegalovirus, toxoplasmosis, syphilis and Zika virus), or due to chronic infection in the infant (as is the case with human immunodeficiency virus [HIV] and hepatitis B and C). In addition, children who are exposed, yet uninfected, may still suffer from the consequences of exposure to infectious pathogens or to the drugs given to treat pregnant women and prevent in utero transmission (as may be the case with HIV infection).
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Thibeau, Shelley, und Karen D’Apolito. „Review of the Relationships Between Maternal Characteristics and Preterm Breastmilk Immune Components“. Biological Research For Nursing 14, Nr. 2 (28.03.2011): 207–16. http://dx.doi.org/10.1177/1099800411400064.
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The immune properties of breastmilk are the most effective preventative means of reducing infant mortality through both passive and active immunity. Breastmilk for term infants has been linked to decreased incidence of respiratory and ear infections and gastrointestinal distress. This protection is even more important for the preterm infant. Prematurity is one of the leading causes of infant death in the United States. Hospitalized infant outcomes associated with consumption of breastmilk are shorter length of stay and decreased incidence of nosocomial infections and necrotizing enterocolitis (NEC). The presence of nosocomial infections and necrotizing enterocolitis increases risk of preterm mortality and morbidity as well as healthcare expenditures. However, breastmilk immunological components such as secretory immunoglobulin A, lactoferrin (LFT), and cytokines provide a framework of immunity that, in conjunction with nutritional support, significantly improves neonatal health. The relationship between maternal characteristics and breastmilk immune properties is central to further the understanding of the impact of breastmilk on preterm infant morbidity and mortality. The purpose of this article is to review the numerous immune components in breastmilk, the moderators of the immune components, and the relevance of these components to preterm/infant health. Exploration of the complexity of breastmilk immune components may direct future development of interventions to improve and sustain the immunological benefits of preterm breastmilk.
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Lapidot, Rotem, Tyler Faits, Arshad Ismail, Mushal Allam, Zamantungwak Khumalo, William MacLeod, Geoffrey Kwenda et al. „Nasopharyngeal Dysbiosis Precedes the Development of Lower Respiratory Tract Infections in Young Infants, a Longitudinal Infant Cohort Study“. Gates Open Research 6 (12.04.2022): 48. http://dx.doi.org/10.12688/gatesopenres.13561.1.
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Background: Infants suffering from lower respiratory tract infections (LRTIs) have distinct nasopharyngeal (NP) microbiome profiles that correlate with severity of disease. Whether these profiles precede the infection or a consequence of it, is unknown. In order to answer this question, longitudinal studies are needed. Methods: We conducted an analysis of a longitudinal prospective cohort study of 1,981 Zambian mother-infant pairs who underwent NP sampling from 1-week through 14-weeks of age at 2-3-week intervals. Ten of the infants in the cohort who developed LRTI were matched 1:3 with healthy comparators. We completed 16S rRNA gene sequencing on the samples each of these infants contributed, as well as from baseline samples of the infants’ mothers, and characterized the normal maturation of the healthy infant NP microbiome, compared to infants who developed LRTI. Results: The infant NP microbiome maturation was characterized by transitioning from Staphylococcus dominant to respiratory-genera dominant profiles during the first three months of life, similar to what is described in the literature. Interestingly, infants who developed LRTI had NP dysbiosis before infection, in most cases as early as the first week of life. Dysbiosis was characterized by the presence of Novosphingobium, Delftia, high relative abundance of Anaerobacillus, Bacillus, and low relative abundance of Dolosigranulum, compared to the healthy controls. Mothers of infants with LRTI also had low relative abundance of Dolosigranulum in their baseline samples compared to mothers of infants that did not develop an LRTI. Conclusions: Our results suggest that NP microbiome dysbiosis precedes LRTI in young infants and may be present in their mothers as well. Early dysbiosis may play a role in the causal pathway leading to LRTI or could be a marker of other pathogenic forces that directly lead to LRTI.
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Eid, Dalia F., Angela Gomez-Simmonds, Vitaliya Boyar, Anne-Catrin Uhlemann und Lorry G. Rubin. „1164. Acquisition of Methicillin-Susceptible Staphylococcus aureus in the Neonatal Intensive Care Unit: Molecular Comparison of Relatedness of Isolates“. Open Forum Infectious Diseases 8, Supplement_1 (01.11.2021): S673—S674. http://dx.doi.org/10.1093/ofid/ofab466.1357.
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Abstract Background In the NICU MSSA infections occur frequently and cause morbidity and mortality. Colonization is a risk factor for infection. Optimal infection prevention strategies await a more complete understanding of acquisition and transmission. To investigate possible transmission, we studied whether newly MSSA colonized infants share a strain with another contemporaneously colonized infant. Methods This is a prospective observational study in a level IV NICU from April through November 2019. Infants had weekly MSSA nasal surveillance cultures. Isolates from newly MSSA colonized infants and other infants colonized with MSSA during the same/previous week were subjected to staphylococcal protein A (spa) typing; most pairs with a concordant (CC) spa type were analyzed by whole genome sequencing (WGS; Illumina MiSeq). Pairs of isolates with a CC spa type and < 25 single nucleotide polymorphism differences on WGS were considered closely related (CC pairs). A control group consisted of pairs of isolates from a newly colonized infant with one randomly chosen colonized infant with a discordant (DC) spa type during the same/previous week. The medical records were reviewed for staff member (SM) and room assignment. Fischer’s exact test was used to compare proportions. Results Isolates from 60/68 consecutive newly MSSA colonized infants and 111/133 comparison infants were available for spa typing. Of these 60 infants, 23 (38 %) had a CC spa type with another infant colonized during the same/previous week. Of 18 isolate pairs from infants with a CC spa type that were subjected to WGS, 12 (67%) pairs of isolates were closely related. 7/12 (58 %) of CC pairs had a SM in common compared to 2/13 (15 %) in the DC pair groups, p=0.04. 2/12 (17 %) of CC pairs shared a room compared to 2/13 (15 %) pairs in the DC group, p=1.0. Conclusion Among newly MSSA colonized infants at least 25% are colonized with an isolate closely related to that of another colonized infant indicating likely infant to infant transmission. WGS is more discriminatory than spa typing for MSSA. Given the lack of commonality of room assignment and the commonality of SM assignment, a possible role of healthcare personnel in MSSA transmission should be further investigated. Disclosures Anne-Catrin Uhlemann, MD, PhD, Merck (Grant/Research Support)
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Puck, Jennifer M., und Andrew R. Gennery. „Establishing Newborn Screening for SCID in the USA: Experience in California“. International Journal of Neonatal Screening 7, Nr. 4 (31.10.2021): 72. http://dx.doi.org/10.3390/ijns7040072.
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Newborn screening for severe combined immunodeficiency (SCID) has developed from the realization that infants affected with SCID require prompt diagnosis and treatment to avoid fatal infectious complications. Screening DNA from infant dried blood spots for T-cell receptor excision circles (TRECs), byproducts of normal antigen-receptor gene rearrangement, has proven to be a reliable method to identify infants with SCID and other serious T lymphocyte defects before the onset of serious infections. The experience of the SCID newborn screening program in California after screening over 3 million infants demonstrates the effectiveness of this measure.
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Betz, Kristina, Matthew Fenchel, Mark C. Steinhoff und Elizabeth P. Schlaudecker. „2632. Cord Blood Vitamin D and Maternal Vaccination Status Associated with Decreased Laboratory Confirmed Influenza Infections in Infants“. Open Forum Infectious Diseases 6, Supplement_2 (Oktober 2019): S918—S919. http://dx.doi.org/10.1093/ofid/ofz360.2310.
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Abstract Background Maternal influenza vaccination has been demonstrated to reduce influenza infections in infants. Influenza infections generally peak during the winter season, and several studies support the association between low levels of vitamin D during winter months and an increase in respiratory infections, including influenza. We examined the effects of vitamin D and maternal influenza vaccination status on laboratory confirmed influenza infections in infants less than 6 months of age. Methods Pregnant Bangladeshi mothers were randomized to receive influenza vaccine or pneumococcal vaccine as part of the Mother’s Gift study. Mothers reported breastfeeding frequency, along with episodes of infant respiratory illness with fever, every week for the first 6 months of life. If a respiratory illness with fever was reported, nasal swabs were obtained from the infant and tested with a commercial rapid influenza test. Infants with confirmed influenza disease were matched with four controls by birth month and sex, for a total of 84 controls. We measured 25-hydroxyvitamin D levels from cord blood in all cases and controls. A conditional logistic regression was performed to test the effect of vitamin D on the odds of laboratory confirmed influenza while controlling for birth weight, gestational age, crowding, number of siblings, and socioeconomic status score. Results A total of 21 infants had laboratory confirmed influenza disease. There were no significant differences in birth weight, crowding, family size, gestational age, socioeconomic status score, infant gender, and smokers in the home between cases and controls (Table 1). Frequency of maternal influenza vaccine was lower in cases when compared with controls (23.81% vs. 58.33%). Serum vitamin D was lower in cases than in controls (8.73 ± 3.34 vs. 10.67 ± 4.08, Table 2). Conclusion Both vitamin D levels and maternal vaccination status have medically relevant, and statistically significant, independent effects on the odds of infants contracting influenza. Although the vitamin D levels in the infants at birth were low, there was a significant association of lower levels at birth with an increased risk of influenza virus infection. Further study with a larger sample-size is needed to explore these effects. Disclosures All authors: No reported disclosures.
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Weatherly, Maggie, Anusua Trivedi, Ratna Chembrolu, Sanjana Gupta, Jan-Marino Ramirez, Juan M. Lavista Ferres, Tatiana M. Anderson und Edwin A. Mitchell. „Maternal infections in pregnancy and the risk of sudden unexpected infant death in the offspring in the U.S., 2011–2015“. PLOS ONE 18, Nr. 4 (21.04.2023): e0284614. http://dx.doi.org/10.1371/journal.pone.0284614.
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Background Infection is thought to play a part in some infant deaths. Maternal infection in pregnancy has focused on chlamydia with some reports suggesting an association with sudden unexpected infant death (SUID). Objectives We hypothesized that maternal infections in pregnancy are associated with subsequent SUID in their offspring. Setting All births in the United States, 2011–2015 Data source Centers for Disease Control and Prevention (CDC) Birth Cohort Linked Birth-Infant Death Data Files. Study design Cohort study, although the data were analysed as a case control study. Cases were infants that died from SUID. Controls were randomly sampled infants that survived their first year of life; approximately 10 controls per SUID case. Exposures Chlamydia, gonorrhea and hepatitis C. Results There were 19,849,690 live births in the U.S. for the period 2011–2015. There were 37,143 infant deaths of which 17,398 were classified as SUID cases (a rate of 0.86/1000 live births). The proportion of the control mothers with chlamydia was 1.7%, gonorrhea 0.2% and hepatitis C was 0.3%. Chlamydia was present in 3.8% of mothers whose infants subsequently died of SUID compared with 1.7% of controls (unadjusted OR = 2.35, 95% CI = 2.15, 2.56; adjusted OR = 1.08, 95% CI = 0.98, 1.19). Gonorrhea was present in 0.7% of mothers of SUID cases compared with 0.2% of mothers of controls (OR = 3.09, (2.50, 3.79); aOR = 1.20(0.95, 1.49)) and hepatitis C was present in 1.3% of mothers of SUID cases compared with 0.3% of mothers of controls (OR = 4.69 (3.97, 5.52): aOR = 1.80 (1.50, 2.15)). Conclusions The marked attenuation of SUID risk after adjustment for a wide variety of socioeconomic and demographic factors suggests the small increase in the risk of SUID of the offspring of mothers with infection with hepatitis C in pregnancy is due to residual confounding.
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St. Jean, Denise T., Roberto Herrera, Claudia Pérez, Lester Gutiérrez, Nadja A. Vielot, Fredman González, Yaoska Reyes et al. „Clinical Characteristics, Risk Factors, and Population Attributable Fraction for Campylobacteriosis in a Nicaraguan Birth Cohort“. American Journal of Tropical Medicine and Hygiene 104, Nr. 4 (07.04.2021): 1215–21. http://dx.doi.org/10.4269/ajtmh.20-1317.
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ABSTRACTCampylobacteriosis is an important contributor to the global burden of acute gastroenteritis (AGE). In Nicaragua, the burden, risk factors, and species diversity for infant campylobacteriosis are unknown. Between June 2017 and December 2018, we enrolled 444 infants from León, Nicaragua, in a population-based birth cohort, conducting weekly household AGE surveillance. First, we described clinical characteristics of symptomatic Campylobacter infections, and then compared clinical characteristics between Campylobacter jejuni/coli and non-jejuni/coli infections. Next, we conducted a nested case–control analysis to examine campylobacteriosis risk factors. Finally, we estimated the population attributable fraction of campylobacteriosis among infants experiencing AGE. Of 296 AGE episodes in the first year of life, Campylobacter was detected in 59 (20%), 39 were C. jejuni/coli, and 20 were non-jejuni/coli species, including the first report of Campylobacter vulpis infection in humans. Acute gastroenteritis symptoms associated with C. jejuni/coli lasted longer than those attributed to other Campylobacter species. In a conditional logistic regression model, chickens in the home (odds ratio [OR]: 3.8, 95% CI: 1.4–9.8), a prior AGE episode (OR: 3.3; 95% CI: 1.4–7.8), and poverty (OR: 0.4; 95% CI: 0.2–0.9) were independently associated with campylobacteriosis. Comparing 90 infants experiencing AGE with 90 healthy controls, 22.4% (95% CI: 11.2–32.1) of AGE episodes in the first year of life could be attributed to Campylobacter infection. Campylobacter infections contribute substantially to infant AGE in León, Nicaragua, with non-jejuni/coli species frequently detected. Reducing contact with poultry in the home and interventions to prevent all-cause AGE may reduce campylobacteriosis in this setting.
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Hofer, Ursula. „Infant respiratory infections disturb microbiota“. Nature Reviews Microbiology 20, Nr. 4 (28.01.2022): 189. http://dx.doi.org/10.1038/s41579-022-00697-x.
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Alba, Claudio, Marta Carrera, Guillermo Álvarez-Calatayud, Rebeca Arroyo, Leónides Fernández und Juan M. Rodríguez. „Evaluation of Safety and Beneficial Health Effects of the Human-Milk Strain Bifidobacterium breve DSM32583: An Infant Pilot Trial“. Nutrients 16, Nr. 8 (11.04.2024): 1134. http://dx.doi.org/10.3390/nu16081134.
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Human milk promotes the growth of bifidobacteria in the infant gut. Adding bifidobacterial species to infant formula may contribute to increasing their presence in the gut of formula-fed infants. Therefore, the safety and anti-infectious effects of Bifidobacterium breve DSM32583, a breast milk isolate, were assessed in a pilot trial involving 3-month-old infants. The infants were randomly assigned to either the probiotic (PG) or the control (CG) groups. All the infants consumed the same formula, although it was supplemented with the strain (1 × 107 cfu/g of formula) in the PG. Overall, 160 infants (80 per group) finished the intervention. Infants in CG gained more weight compared to PG (p < 0.05), but the weights for age Z-scores at 6 months were within the normal distribution for this age group. The rates of infections affecting the gastrointestinal and respiratory tracts and antibiotic therapy were significantly lower in the PG. The bifidobacterial population and the level of short-chain fatty acids were higher (p < 0.05) in the fecal samples of PG infants. No adverse events related to formula consumption were observed. In conclusion, the administration of an infant formula with B. breve DSM32583 was safe and exerted potential beneficial effects on gut health.
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Lee, Benjamin, Md Abdul Kader, Masud Alam, Dorothy M. Dickson, Patrick Harvey, E. Ross Colgate, Mami Taniuchi, William A. Petri, Rashidul Haque und Beth D. Kirkpatrick. „Infant Non-Secretor Histoblood Group Antigen Phenotype Reduces Susceptibility to Both Symptomatic and Asymptomatic Rotavirus Infection“. Pathogens 13, Nr. 3 (04.03.2024): 223. http://dx.doi.org/10.3390/pathogens13030223.
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The infant non-secretor histoblood group antigen phenotype is associated with reduced risk of symptomatic rotavirus diarrhea, one of the leading global causes of severe pediatric diarrheal disease and mortality. However, little is known regarding the role of secretor status in asymptomatic rotavirus infections. Therefore, we performed a nested case–control study within a birth cohort study previously conducted in Dhaka, Bangladesh, to determine the association between infant secretor phenotype and the odds of asymptomatic rotavirus infection, in addition to the risk of rotavirus diarrhea, in unvaccinated infants. In the parent cohort, infants were enrolled in the first week of life and followed through the first two years of life with multiple clinic visits and active surveillance for diarrheal illness. Secretor phenotyping was performed on saliva. Eleven surveillance stools collected over the first year of life were tested for rotavirus by real-time RT-PCR, followed by conventional PCR and amplicon sequencing to identify the infecting P-type of positive specimens. Similar to findings for symptomatic diarrhea, infant non-secretors experienced significantly fewer primary episodes of asymptomatic rotavirus infection through the first year of life in a likely rotavirus P-genotype-dependent manner. These data suggest that non-secretors experienced reduced risk from rotavirus due to decreased susceptibility to infection rather than reduced infection severity.
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Savicheva, Alevtina M. „Perinatal infections in the Russian Federation. Screening strategies: problems and prospectives“. Journal of obstetrics and women's diseases 62, Nr. 3 (15.06.2013): 70–76. http://dx.doi.org/10.17816/jowd62370-76.
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The article describes principal problems of the diagnosis and prevention of perinatal infections in the Russian Federation. Data on the prevalence of infectious diseases in pregnant women, the ways of transmission of infection from mother to fetus and newborn infant, as well as adverse effects are discussed. Possible ways of solving the current problems are suggested, such as the development of standards and algorithms of diagnosis and prevention of infections during pregnancy planning and early pregnancy terms.
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Sohail, Shagufta, Kaneez Fatima und Noshina Riaz. „Breast Feeding Remains a Strong Protection against Infant Infections.“ Journal of Islamabad Medical & Dental College 8, Nr. 4 (23.12.2019): 203–7. http://dx.doi.org/10.35787/jimdc.v8i4.351.
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Background: Breast feeding prevents infections in infants. Those who are partially or never breast-fed and receiving bottle feeds are at higher risk of infections as compared to exclusive breast-fed infants. The objectives of this study were to record the effect of exclusive breast feeding versus partial and never breast feeding on infections in infants and also to find an association of infection with type of feed, gestation and vaccination status in infants till six months of age.Material and Methods: A total of 500 Infants were included in this cross-sectional study. Information regarding pattern of feeding and infections was obtained by verbal interview of mother and the questionnaire was filled by the study physician. The outcome evaluated was infections in infants till one year of age. Categorical comparisons were made using chi square test. A ‘p’ value < 0.05 was considered statistically significant.Results: Out of 500 infants, 59.4% were males. About 59.6% were exclusively breast-fed till 6 months of age, 31.2% were partially breast-fed and 9.2% were never breast-fed. In exclusively breast-fed group, 29.5% infants reported infections as compared to 40.4% in partial breast-fed group and 65.2% in never breast-fed infants (P < 0.000). Similarly, 40.6% of infants in exclusively breast-fed group, 55.1% in partial breast feed and 58.7% in the never breast-fed reported infections in 4-6 months of age, which was statistically significant (P = 0.003). There was no significant difference in infection rates among the three study groups in 7-9 (P=0.192) and 10 -12 months (P=0.42) of age.Conclusions: Exclusive breast feeding till six months of age significantly reduces the risk of infections in infancy.
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Koziej, Sylwia, Emilia Kowalczyk, Martyna Niemczuk, Adrianna Jasiuk und Mateusz Wiekiera. „Congenital CMV Infection: A Complex Case of Neurological Complications and Therapeutic Approaches in Infancy“. Journal of Education, Health and Sport 54 (20.01.2024): 158–68. http://dx.doi.org/10.12775/jehs.2024.54.012.
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Introduction and purpose
Congenital Cytomegalovirus (CMV) infection stands as the prevalent infection among newborns and it may be associated with later complications such as progressive sensorineural hearing loss or neurological diseases. Infection occurs during pregnancy or during childbirth. Congenital CMV infections manifest in various ways, ranging from asymptomatic cases to severe complications such as microcephaly, hepatosplenomegaly, and chorioretinitis. Routine antibody screenings for pregnant women are not common, underlining the significance of early infection detection to minimize the risks of transmission to the fetus and potential complications in the child.
The aim of this case report is to present the course of congenital CMV infection and its complication. This case report explores the challenges of managing an infant with congenital CMV infection complicated by hydrocephalus and viral co-infections. The infant underwent various treatments, including antiviral therapy, highlighting the need for multidisciplinary approaches.
Conclusion
With no available vaccine, prevention of congenital CMV infection relies on educating reproductive-age women and expectant mothers about infection risks. Early detection, frequent medical check-ups, and preventive education are crucial due to the absence of vaccines. Ongoing exploration of antiviral treatments and prompt interventions is imperative to improve outcomes for infants and families affected by the virus.
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Wilkinson, Amanda L., Sarah H. Pedersen, Urassa Mark, Michael Denna, Andreasen Aura, Todd Jim, Safari M. Kinung'hi, Changalucha John und Joann M. McDermid. „Evaluating mild cachexia syndrome in the HIV-positive pregnant woman“. African Journal of Midwifery and Women's Health 13, Nr. 4 (02.10.2019): 1–13. http://dx.doi.org/10.12968/ajmw.2018.0015.
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Background Immune activation and inflammation are common symptoms throughout HIV infection and lead to elevated circulating concentrations of cachectic cytokines. Aims To evaluate cachexia-like symptoms among HIV-positive and HIV-negative pregnant women, and investigate whether cachexic mechanisms may contribute to impaired HIV-exposed fetal and infant growth. Methods Pregnant women (n=114; 39% HIV-positive) were prospectively enrolled from an antenatal clinic in semi-rural Tanzania. Maternal cachexia-associated plasma cytokines and hormones, and clinical and anthropometric data were assessed. Cachexia scores were quantified using a novel adaptation of a validated cachexia scoring system. Infant growth anthropometry was measured at birth and after 6 months. Results Maternal cachexia score was inversely associated with infant birth weight, birth length, and weight-for-age z-score at 6 months. Conclusions Symptoms consistent with a mild cachectic state were associated with poorer infant outcomes. This effect was greater for HIV-exposed infants. A better understanding of the maternal cachexia burden and implications for maternal and infant health in HIV, other infections, and inflammatory conditions is needed.