scholarly journals Longitudinal Colonization With Streptococcus pneumoniae During the First Year of Life in a Healthy Newborn Cohort

2019 ◽  
Vol 9 (4) ◽  
pp. 442-448
Author(s):  
Sharon B Meropol ◽  
Michael R Jacobs ◽  
Kurt C Stange ◽  
Saralee Bajaksouzian ◽  
Robert A Bonomo

Abstract Background The objective of this study was to characterize longitudinal colonization with Streptococcus pneumoniae during the first year of life within a community newborn infant cohort, and assess the relationship between antibiotic exposure and colonization with antibiotic-resistant organisms. Methods During April 2013–February 2014, 326 infants were enrolled from an urban academic hospital well-baby nursery. At ages 4, 8, and 12 months, we collected antibiotic data, other exposure data, and nasopharyngeal cultures for pneumococcal isolation. Results Follow-up visits were completed for 211, 158, and 144 infants at ages 4, 8, and 12 months, respectively. By 12 months, 33% of infants attending the visits had ever been exposed to antibiotics, 67% if exposures to maternal antibiotics at birth are included. Pneumococci were isolated at 38/839 (4.5%) visits from 38 infants, including one 13-valent conjugate vaccine (PCV13) serotype (6A). There were 1 (0.3%), 15 (7%), 7 (4%), and 15 (10%) infants who were colonized at 0-, 4-, 8-, and 12-month visits, respectively. By age 12 months, at least 35 (11%) infants had ever been colonized. Sixteen isolates (42%) exhibited nonsusceptibility to at least 1 antibiotic. Infants with recent antibiotic exposure were not more likely to be colonized or to harbor nonsusceptible organisms. Conclusions Within a hospital birth cohort followed in the community, pneumococcal colonization and related antibiotic resistance were lower than previously reported, likely associated with PCV13 use. Antibiotic exposure was not associated with subsequent colonization with resistant isolates. The influence of other environmental factors needs further study.

2019 ◽  
Vol 24 (4) ◽  
pp. 415-422 ◽  
Author(s):  
Bianca K. den Ottelander ◽  
Robbin de Goederen ◽  
Marie-Lise C. van Veelen ◽  
Stephanie D. C. van de Beeten ◽  
Maarten H. Lequin ◽  
...  

OBJECTIVEThe authors evaluated the long-term outcome of their treatment protocol for Muenke syndrome, which includes a single craniofacial procedure.METHODSThis was a prospective observational cohort study of Muenke syndrome patients who underwent surgery for craniosynostosis within the first year of life. Symptoms and determinants of intracranial hypertension were evaluated by longitudinal monitoring of the presence of papilledema (fundoscopy), obstructive sleep apnea (OSA; with polysomnography), cerebellar tonsillar herniation (MRI studies), ventricular size (MRI and CT studies), and skull growth (occipital frontal head circumference [OFC]). Other evaluated factors included hearing, speech, and ophthalmological outcomes.RESULTSThe study included 38 patients; 36 patients underwent fronto-supraorbital advancement. The median age at last follow-up was 13.2 years (range 1.3–24.4 years). Three patients had papilledema, which was related to ophthalmological disorders in 2 patients. Three patients had mild OSA. Three patients had a Chiari I malformation, and tonsillar descent < 5 mm was present in 6 patients. Tonsillar position was unrelated to papilledema, ventricular size, or restricted skull growth. Ten patients had ventriculomegaly, and the OFC growth curve deflected in 3 patients. Twenty-two patients had hearing loss. Refraction anomalies were diagnosed in 14/15 patients measured at ≥ 8 years of age.CONCLUSIONSPatients with Muenke syndrome treated with a single fronto-supraorbital advancement in their first year of life rarely develop signs of intracranial hypertension, in accordance with the very low prevalence of its causative factors (OSA, hydrocephalus, and restricted skull growth). This illustrates that there is no need for a routine second craniofacial procedure. Patient follow-up should focus on visual assessment and speech and hearing outcomes.


2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Dalal Alkazemi ◽  
Munirah Albeajan ◽  
Stan Kubow

Objective. Early feeding and infant exposures have been suggested as potential risk factors for immunoglobulin E- (IgE-) mediated food allergy (FA). We aimed to evaluate the association between IgE-mediated FA in children and early exposures including the child’s nutritional status, breastfeeding and its duration, the age at which the solid food was first introduced, antibiotic exposure during the first year of life, and the child’s vitamin D status during infancy. Design. A case-control study. Setting and Subjects. Children aged 0–13 years were recruited from pediatric allergy and immunology clinics (PAICs) located at major government hospitals in Kuwait (total FA cases: n=100; boys = 67%), and healthy controls (n=100, boys 55%) were recruited from various vaccination units at primary healthcare centers. Results. Cow’s milk allergy was the most common type of FA. FA status was independently associated with the early exposures of exclusive breastfeeding (aOR = 15.55 (3.26–74.19), p=0.001), vitamin D deficiency or insufficiency during infancy (aOR = 5.42 (1.92–15.30), p=0.001), and antibiotic exposure during the first year of life (aOR = 5.00 (1.58–15.84), p=0.006). Conclusions. FA is highly prevalent among children in Kuwait, and our data indicate that early nutrition-related and antibiotic exposures are associated with FA risk.


PEDIATRICS ◽  
1982 ◽  
Vol 69 (5) ◽  
pp. 537-543
Author(s):  
Marie C. McCormick ◽  
Sam Shapiro ◽  
Barbara Starfield

A mother's expectations about the development of her infant have been found to be a strong determinant of child development, but little is known about the factors that may affect maternal assessment of development. In this study, the relationship of the mother's opinion of the development of her infant with several sociodemographic, antenatal, intrapartum, and infant health variables was examined for a large sample of 1-year-old infants for whom gross motor observations were also obtained at the time of the interview. Among those observed to be developing at an appropriate rate, 4.0% were perceived by their mothers as developing more slowly than the mothers considered normal; among infants developing more slowly, 28.6% were considered to be developing slowly by their mothers. In both groups, the major determinants of maternal opinion of slow development concerned the infant's health: low birth weight, congenital anomalies regardless of severity, hospitalization during the first year of life, and high ambulatory care use. These results indicate that maternal perception of infant development may not reflect the infant's level, but past or present illness, and raise questions about the influence of infant health on maternal-infant interactions and the effect of such interactions on subsequent development in the child.


PEDIATRICS ◽  
1986 ◽  
Vol 77 (5) ◽  
pp. 664-669
Author(s):  
Michael K. Georgieff ◽  
Judy C. Bernbaum

To document the incidence of and neonatal factors associated with abnormal shoulder girdle muscle tone in premature infants at follow-up, we studied 125 consecutively admitted infants weighing &lt; 1,750 g treated in The Children's Hospital of Philadelphia intensive care nursery and subsequently seen in the Neonatal Follow-up Program up to 18 months of age. Fifty-seven infants (46%) displayed abnormal shoulder girdle muscle tone which presented clinically as scapular retractions. These infants had significantly lower birth weights (P &lt; .001) and gestational age (P &lt; .001) as well as a higher incidence of acute and chronic pulmonary disease (P &lt; 0.01) and CNS insults (P &lt; .05) when compared with infants without scapular retractions. The 57 infants with scapular retractions were further divided into two groups: 42 infants (74%) in whom scapular retractions were associated with generalized mild hypertonicity and 15 infants (26%) in whom scapular retractions compensated for trunk and neck hypotonicity. The infants with scapular retractions and hypotonicity had a significantly higher incidence of neonatal neurologic morbidity including seizures, major resuscitations, and birth asphyxia (P &lt; .01) when compared with the infants with scapular retractions and hypertonicity. Shoulder girdle tone abnormalities in the first year of life inhibit crawling, sitting, and object manipulation and, therefore, may manifest as delays in motor development. Identification of infants with significant neonatal risk factors for tone abnormalities is important to allow for earlier therapeutic intervention.


2020 ◽  
Vol 7 (4) ◽  
pp. e757
Author(s):  
Andrea Ines Ciplea ◽  
Annette Langer-Gould ◽  
Anna Stahl ◽  
Sandra Thiel ◽  
Annette Queisser-Wahrendorf ◽  
...  

ObjectiveTo determine whether potential breast milk exposure to interferon-beta (IFN-β) or glatiramer acetate (GA) is safe for the infant.MethodsWe identified 74 infants born to 69 women with MS who breastfed under IFN-β (n = 39), GA (n = 34), or both (n = 1). Women had been enrolled into the German Multiple Sclerosis and Pregnancy Registry during pregnancy. Data were obtained from standardized, telephone-administered questionnaires completed by the mother during pregnancy and at 1, 3, 6, and 12 months postpartum and the infant's take-home medical record.ResultsThe median duration of exposed breastfeeding was 8.5 months (wide interquartile range: 4.9–12.7 months). Physical growth curves during the first year of life were consistent with national, sex-specific growth curves. Median body measurements were consistent with national medians. Most children (n = 71, 96%) had normal motor and language development. Gross motor delay was reported in 3 children, of whom 1 remained delayed at last follow-up (3.9 years old) and 2 were normal by 0.9 and 4.1 years old. The proportion of children hospitalized at least once (girls n = 2, 7%, and boys n = 6, 14%) and the proportion of children with at least one episode of systemic antibiotic use during the first year of life (girls n = 7, 23%, and boys n = 8, 18%) are consistent with national averages.ConclusionPotential breast milk exposure to IFN-β or GA did not increase the risk of common adverse infant outcomes in the first year of life. Taken together with the benefits of breastfeeding and low biological plausibility of risk, women with MS who wish to resume IFN-β or GA postpartum can be encouraged to breastfeed.


Author(s):  
vito terlizzi ◽  
Laura Claut ◽  
Carla Colombo ◽  
Antonella Tosco ◽  
Alice Castaldo ◽  
...  

Background: Reaching early and definitive diagnosis in infants with cystic fibrosis (CF) transmembrane conductance regulator-related metabolic syndrome (CRMS)/CF screen-positive, inconclusive diagnosis (CFSPID) is a priority of all CF newborn screening programs. Currently, sweat testing is the gold standard for CF diagnosis or exclusion. We assessed outcomes in a cohort of Italian CRMS/CFSPID infants who underwent repeat sweat testing in the first year of life. Methods: This multicentre, prospective study analysed clinical data and outcomes in CRMS/CFSPID infants born between September 1, 2018 and December 31, 2019, and followed until June 30, 2020. All subjects underwent CF transmembrane conductance regulator (CFTR) gene sequencing and the search for CFTR macrodeletions/macroduplications, and repeat sweat testing in the first year of life. Results: Fifty subjects (median age at end of follow-up, 16 months [range, 7–21 months]) were enrolled. Forty-one (82%) had the first sweat chloride in the intermediate range. During follow up, 150 sweat tests were performed (range, 1–7/infant). After a median follow-up of 8.5 months (range 1–16.2 months), 11 (22%) subjects were definitively diagnosed as follows: CF (n=2 [4%]) at 2 and 5 months, respectively; healthy carrier (n=8 [16%]), at a median age of 4 months (range 2–8 months); and healthy (n=1 [2%]) at 2 months of age. Inconclusive diagnosis remained in 39 (78%) infants. Conclusions: Early repeat sweat testing in the first year of life can shorten the time to definitive diagnosis in screening positive subjects with initial sweat chloride levels in the intermediate range.


PEDIATRICS ◽  
1968 ◽  
Vol 41 (5) ◽  
pp. 945-954
Author(s):  
Fernando Torres ◽  
Michael E. Blaw

One hundred-thirty children who had an EEG during their first days of life and who were registered in a clinical longitudinal study were followed with concurrent clinical and EEG examinations every 4 months for the first year of life and at 2, 3, and 4 years of age. Thirty children had EEG characteristics which are frequently considered abnormal in their neonatal record. Twenty-three children had clinical abnormalities during the 4-year period covered by the study. There was no significant correlation between a single EEG and clinical abnormalities at any age. Newborn infants with more than one focal abnormality in their EEG presented clinical abnormalities more frequently than those with a single focus. The difference, however, did not attain statistical significance. Children with an abnormal EEG at birth and an additional abnormal record later, had a higher incidence of clinical abnormalities than those with only an abnormal neonatal EEG. However, this finding is of questionable significance because the children who had clinical abnormalities had a larger number of EEG's than the normal subjects. It is expected that continued follow-up of these children at more advanced stages of their development may give a positive EEG-clinical correlation which was not found in this study.


Author(s):  
Fatih Akova

Objective: The aim of this study is to present the frenotomy technique in cases of ankyloglossia (tongue-tie), which is diagnosed and treated in the first year of life. Patients were operated by a single surgeon. Method: Cases of ankyloglossia operated at Biruni University Faculty of Medicine Hospital Pediatric Surgery Clinic Between 2016-2020 were evaluated retrospectively in terms of clinical complaints, age, type of ankyloglossia, surgical technique, indications and results of surgery. Results: Frenotomy was performed in 56 patients including 47 boys (84%) and 9 girls (16%), between the ages of 0-1. Average age of the patients was 93 days (1-360). Patients were divided into two groups as Group 1 (n: 40: 0-90 days old) and Group 2 (n: 16: 90-360 days old). Patients were admitted with complaints of having difficulty in sucking the mother’s breast, not being able to take their tongue out, feeding with a bottle, pain at the nipple and not being able to grasp the breast. No additional intervention was required for bleeding in Group 1, and in 12 (75%) patients in Group 2 bleeding control was achieved using bipolar cautery. During follow-up, significant improvement was obtained in all patients who had difficulty in sucking and gripping the nipple. Improvement was observed in 15 of 25 patients with nipple pain. Conclusion: Frenotomy is an easily applied surgical procedure with minimal complications. Additional application may be required for bleeding control in infants older than 3 months. It should be considered that the probability of recurrence may depend on the type, intervention used and thickness of the frenulum, and phrenotomy may not be sufficient. The improvement in breast feeding function of Frenotomy may provide a significant improvement in the complaints of nipple pain, and may contribute to the emotional attachment between the mother and her baby. Randomized controlled trials are required to determine the effects of phrenotomy.


1982 ◽  
Vol 63 (4) ◽  
pp. 5-7
Author(s):  
E. A. Efimova ◽  
S. L. Nesterov ◽  
N. L. Yashina ◽  
T. K. Shakurova ◽  
V. A. Novikova ◽  
...  

Clinical, cytochemical, and rheological features of the neonatal period were studied in 460 children from mothers suffering from rheumatism or having suffered late toxicosis of pregnant women. On the basis of impaired adaptive reactions, changes in the enzymatic spectrum of blood cells and disorders of microcirculatory mechanisms, children at risk were identified. 50 of them underwent preventive therapy in the neonatal period. The follow-up indicates a lower infectious index during the first year of life in children who received preventive therapy.


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