scholarly journals A prospective cohort study of confirmed severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection during pregnancy evaluating SARS‐CoV‐2 antibodies in maternal and umbilical cord blood and SARS‐CoV‐2 in vaginal swabs

Author(s):  
Julie Milbak ◽  
Victoria M. F. Holten ◽  
Paul Bryde Axelsson ◽  
Jane Marie Bendix ◽  
Anna J. M. Aabakke ◽  
...  
2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S39-S40
Author(s):  
Larry Kociolek ◽  
Ciaran P Kelly ◽  
Robyn Espinosa ◽  
Maria Budz ◽  
Aakash Balaji ◽  
...  

Abstract Background Infant C. difficile colonization is common, but the molecular epidemiology and immunologic consequences of colonization are poorly understood. Methods In this prospective cohort study of healthy infants, serial stools collected between 1–2 and 9–12 month olds were tested for glutamate dehydrogenase (detects nontoxigenic or toxigenic C. difficile [TCD]), tcdB PCR (detects TCD), and cultured for C. difficile. Isolates underwent whole genome sequencing and multilocus sequence typing (MLST). Clonal strains were identified by single nucleotide variant (SNV) analysis. TCD was confirmed by BLAST identification of tcdA/tcdB. Serum collected at 9–12 month olds underwent ELISA for measurement of IgA, IgG, and IgM against TCD toxins A and B. For comparison, anti-toxin IgG was measured in cord blood of 50 consecutive full-term deliveries (unrelated to study infants). Arbitrary ELISA units were compared by Wilcoxon rank-sum test. Results Among 32 infants, 16 (50%) had at least one TCD+ stool, 12 of whom were colonized at least 1 m prior to serology measurements (Figures 1 and 2). A variety of STs were identified, and evidence of putative in-home (enrolled siblings) and outpatient clinic transmission was identified (Figure 3). Infants with TCD colonization had significantly greater levels of anti-toxin IgA and IgG compared with non-colonized infants and IgG compared with unrelated cord blood (Table 1). Conclusion Infant C. difficile colonization is a dynamic process with variable strain types and duration. Outpatient clinics may be a C. difficile reservoir for some patients. TCD colonization is associated with a humoral immune response against toxins A and B, but whether natural TCD immunization protects against CDI later in life requires further investigation. Disclosures L. Kociolek, Alere/Techlab: Investigator, Research support. C. P. Kelly, Actelion: Consultant, Consulting fee. Artugen: Consultant, Consulting fee. Facile: Consultant, Consulting fee. GSK: Consultant, Consulting fee. MSD: Consultant, Consulting fee. Seres: Consultant, Consulting fee. Summit: Consultant, Consulting fee. Vedanta: Consultant, Consulting fee. D. N. Gerding, Merck: Scientific Advisor, Consulting fee. Actelion: Scientific Advisor, Consulting fee. DaVolterra: Scientific Advisor, Consulting fee. Summit: Scientific Advisor, Consulting fee. Rebiotix: Medical Officer and Scientific Advisor, Consulting fee. Pfizer: Consultant, Consulting fee. MGB Pharma: Consultant, Consulting fee. sanofi pasteur: Consultant, Consulting fee. Seres: Investigator, Research grant. CDC: Investigator, Research grant. US Dept VA: Investigator, Research grant. Treatment/Prevention of C. difficile: Patent Holder, no license or royalties.


2019 ◽  
Vol 95 (7) ◽  
pp. 505-510 ◽  
Author(s):  
Genevieve A F S van Liere ◽  
Christian J P A Hoebe ◽  
Jeanne AMC Dirks ◽  
Petra FG Wolffs ◽  
Nicole H T M Dukers-Muijrers

ObjectiveChlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections can clear without treatment. Despite high prevalence of anorectal infections in men who have sex with men (MSM) and women, studies on anorectal clearance are scarce. Moreover it is unknown whether bacterial load affects urogenital/anorectal CT clearance. In this prospective cohort study, CT and NG clearance is assessed at three anatomical sites of men and women.MethodsCT-positive and NG-positive MSM, heterosexual men and women ≥18 years of age visiting our STI clinic between 2011 and 2013 underwent a repeat test when returning for treatment (n=482). The primary outcome was clearance, defined as a positive nucleic acid amplification test (NAAT) at screening-consultation, followed by a negative NAAT at treatment-consultation. Sociodemographics, sexual risk behaviour and CT bacterial load (inhouse quantitative PCR) were tested as determinants for clearance using multivariable logistic regression for CT and Fisher’s exact test for NG.ResultsCT clearance was 9.1% (10/110) for urine, 6.8% (20/292) for vaginal swabs, 12.7% (8/63) for anorectal swabs (ie, 4.0% [1/25] in MSM and 18.4% [7/38] in women) and 57.1% (4/7) for oropharyngeal swabs. For NG this was 33.3% (2/6), 28.6% (2/7), 20.0% (2/10) and 27.3% (6/22), respectively. The number of days between tests (median 10, IQR 7–14) was not associated with clearance. Lower bacterial load at screening was the only predictor for CT clearance (urine mean 1.2 vs 2.6 log CT/mL, p=0.001; vaginal swabs mean 2.1 vs 5.2 log CT/mL p<0.0001; anorectal swabs mean 2.0 vs 3.7 log CT/mL, p=0.002). None of the tested determinants were associated with NG clearance.ConclusionsThis study reports the largest number of anorectal infections tested for CT and NG clearance to date. Clearance in all sample types was substantial: between 7% and 57% for CT, and between 20% and 33% for NG (notwithstanding low absolute numbers). CT clearance was associated with a lower load at screening. However, not all individuals with low bacterial CT load cleared the infection, hampering STI guideline change.


2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Bo Y. Park ◽  
Brian K. Lee ◽  
Igor Burstyn ◽  
Loni P. Tabb ◽  
Jeff A. Keelan ◽  
...  

2008 ◽  
Vol 13 (3) ◽  
pp. 415-423 ◽  
Author(s):  
Wieslaw Jedrychowski ◽  
Frederica Perera ◽  
Elzbieta Mroz ◽  
Susan Edwards ◽  
Elzbieta Flak ◽  
...  

2018 ◽  
Vol 46 (6) ◽  
pp. 593-598 ◽  
Author(s):  
Marwan Ma’ayeh ◽  
Evan McClennen ◽  
Dmitri Chamchad ◽  
Michael Geary ◽  
Norman Brest ◽  
...  

Abstract Background: The umbilical coiling index (UCI) is a measure of the number of coils in the umbilical cord in relation to its length. Hypercoiled cords with a UCI of >0.3 coils/cm have been associated with adverse fetal and neonatal outcomes. Aims: The primary aim is to determine the accuracy of UCI measured on second trimester ultrasound in predicting UCI at birth. The secondary outcome is to investigate the association between hypercoiling of the umbilical cord on prenatal ultrasound and adverse maternal, fetal and neonatal outcomes. Methods: This was a prospective cohort study of uncomplicated singleton pregnancies. Seventy two patients were included in the study. UCI was measured in the second trimester ultrasound, and compared to UCI measured postnatally. Outcomes of patients with hypercoiled cords on ultrasound were compared to outcomes of patients with normocoiled cords. Results: Our results failed to show a strong correlation between the UCI determined with ultrasound, and the UCI determined with examination of the umbilical cord after delivery. We also did not demonstrate that measurement of the UCI on second trimester ultrasound is able to predict adverse maternal, fetal or neonatal outcomes. Conclusion: This study suggests that measurement of the umbilical coiling index should not be part of routine second trimester sonography in patients with uncomplicated singleton pregnancies, with no other medical or surgical comorbidities.


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