Assuntos
Antivirais/uso terapêutico , Herpes Simples/tratamento farmacológico , Feminino , Herpes Genital/tratamento farmacológico , Herpes Labial/tratamento farmacológico , Humanos , Recém-Nascido , Doenças do Recém-Nascido/transmissão , Ceratoconjuntivite/tratamento farmacológico , Masculino , Meningoencefalite/tratamento farmacológico , Gravidez , Complicações Infecciosas na Gravidez/transmissãoRESUMO
An outbreak of viral respiratory disease occurred in eight infants in a neonatal intensive care unit during the 1980 winter respiratory season. Four infections with respiratory syncytial virus and four infections with rhinovirus were identified. Epidemiologic investigation revealed that viral respiratory infection was significantly associated with intubation with orotracheal tubes (P = 0.001), with the presence of both a nasal feeding tube plus an orotracheal tube together (P = 0.007), and with assisted ventilation (P = 0.009) when compared to uninfected controls. Twenty-seven of 85 (30.6%) personnel working in the unit at the time of the outbreak reported a history of upper respiratory illness during the week prior to the outbreak, and 46 (54.1%) of them had had contact with patients in areas of the hospital where patients infected with RSV and rhinovirus were housed. The data suggest that both viruses were transmitted to the babies by hospital personnel. Rhinoviruses can be nosocomial pathogen in neonates with compromised pulmonary function, and the clinical presentation of rhinovirus infection in neonates may be difficult to distinguish from that produced by RSV.
Assuntos
Infecção Hospitalar/transmissão , Doenças do Recém-Nascido/transmissão , Infecções por Picornaviridae/transmissão , Doenças Respiratórias/transmissão , Infecções por Respirovirus/transmissão , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Intubação Intratraqueal/efeitos adversos , Testes de Neutralização , Recursos Humanos em Hospital , Vírus Sinciciais Respiratórios , Rhinovirus , RiscoRESUMO
Over a four-month period, urine specimens for viral isolation were obtained weekly from all infants older than three weeks in two intensive care nurseries. These babies comprised 43% of the patients in the nurseries surveyed. Cytomegalovirus was cultured from 13 of 93 (14%) of these infants. Eleven of 13 infants who developed cytomegaloviruria were born prematurely, and nine of these 11 were found to be excreting CMV before they reached 40 weeks postconception. Infants excreting CMV received blood transfusions from a mean of 10.45 (+/- 1.80 SE) different donors versus 5.10 (+/- 0.55 SE) for infants without viruria (P less than 0.002) and five of 14 infants undergoing one or more exchange transfusions developed cytomegaloviruria (P less than 0.05). The possible role of other CMV reservoirs and the importance of these findings are discussed.
Assuntos
Infecções por Citomegalovirus/epidemiologia , Doenças do Recém-Nascido/epidemiologia , Unidades de Terapia Intensiva , Berçários Hospitalares , Infecção Hospitalar/transmissão , Citomegalovirus/isolamento & purificação , Infecções por Citomegalovirus/transmissão , Transfusão Total/efeitos adversos , Humanos , Recém-Nascido , Doenças do Recém-Nascido/transmissão , Reação TransfusionalAssuntos
Doenças do Recém-Nascido/epidemiologia , Sepse/epidemiologia , Infecções Estreptocócicas/epidemiologia , Canal Anal/microbiologia , Orelha/microbiologia , Feminino , Humanos , Lactente , Recém-Nascido , Doenças do Recém-Nascido/transmissão , Masculino , Meningite/epidemiologia , Faringe/microbiologia , Gravidez , Estudos Prospectivos , Risco , Sepse/transmissão , Infecções Estreptocócicas/transmissão , Streptococcus agalactiae/isolamento & purificação , Umbigo/microbiologia , População Urbana , Vagina/microbiologiaRESUMO
The incidence of necrotizing enterocolitis encountered in neonates fed only refrigerated human milk was comparable to that in infants fed milk and isotonic formula or isotonic formula alone. The infants fed human milk were significantly (P less than 0.05) smaller, less mature, had lower Apgar scores, and were fed later than the formula-fed infants. The mean age of onset and time between first feeding and onset of NEC was similar among the three groups. These data indicate that refrigerated human milk was not effective in lowering the incidence of NEC. Possible explanations for the occurrence of NEC in neonates fed human milk include: (1) the introduction of a pathogen via contaminated milk; (2) inadequate maternal antigenic stimulation by the neonatal gastrointestinal flora; and (3) adverse affects of storage on cell number and function.