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Abstract
An outbreak of PIV-3 in a neonatal ICU was investigated using a retrospective cohort study. Risk of infection increased with lower birth weight and gestational age. Contact with sick visitor(s)/staff was not associated with infection (P = 0.212, P = 0.299). Transmission routes are difficult to identify, and the importance of visiting restrictions and sickness absence during outbreaks is recommended.
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Hon KL, Ting JY, Chow CM, Wong W, Lau WH, Yeung WT, Hung KKI, Lee C, Lee TCS, Li KKK, Leung TF. Microbiologic Agents in Parent-reported Neonatal Fever. J Trop Pediatr 2015; 61:448-54. [PMID: 26403169 DOI: 10.1093/tropej/fmv057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We reviewed etiology and outcome of consecutive neonates admitted to a neonatal unit for investigation of parent-reported fever (116 neonates over 24 months). Tympanic temperature was measured at the emergency department (Te) and core temperature at the neonatal unit (Tn). Microbials were isolated in 27 patients (23%); Te and Tn were both <38°C in 13 (48%) of the 27 patients. Microbial isolation was associated with older median age (16.7 vs. 8.0 days, p = 0.004), empirical antibiotic commencement (p = 0.0003) and longer hospital stay (median 8 vs. 4.0 days, p = 0.004). Compared with respiratory viral infection, patients with bacteremia had high C-reactive protein (p = 0.005) and likely to have comorbidity of meningitis (p = 0.077). Te ≥38°C had the highest sensitivity, positive likelihood ratio and positive and negative predictive ratios for bacteremia. Parent-reported fever was associated with a 3% incidence of meningitis, 6% of bacteremia and 9% of urinary tract infection. The majority of neonates with parent-reported fever do not have serious bacterial infection. Nevertheless, recommendations about threshold of antibiotic initiation are difficult, and empirical systemic antibiotic coverage must be commenced in those neonates with Te ≥38°C or elevated C-reactive protein.
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Affiliation(s)
- Kam Lun Hon
- Departments of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Joseph Yuk Ting
- Division of Neonatology, Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Chung Mo Chow
- Departments of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - William Wong
- Departments of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Wan Hang Lau
- Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wai Tat Yeung
- Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | - Carolyn Lee
- Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | - Ka Kei Kieran Li
- Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ting Fan Leung
- Departments of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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Hon KL, Leung TF, Cheng WY, Ko NMW, Tang WK, Wong WW, Yeung WHP, Chan PK. Respiratory syncytial virus morbidity, premorbid factors, seasonality, and implications for prophylaxis. J Crit Care 2012; 27:464-8. [DOI: 10.1016/j.jcrc.2011.12.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 11/21/2011] [Accepted: 12/01/2011] [Indexed: 10/14/2022]
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Horizontal transmission of novel H1N1/09 influenza virus in a newborn: Myth or fact? JOURNAL OF ACUTE DISEASE 2012. [PMCID: PMC7147896 DOI: 10.1016/s2221-6189(13)60042-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Horizontal transmission of H1N1/09 virus infection is very common however; transmission through this route has not been reported in newborns. To our knowledge, this is the first case report of newborn who acquired infection of novel H1N1/09 virus horizontally through asymptomatic family members or hospital staff during epidemic period in Kolkata, India. Baby recovered without antiviral therapy but received antibiotic for bacterial co-infection.
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Wiwanitkit V. Novel H1N1 influenza pneumonia in neonate. Pediatr Pulmonol 2011; 46:412; author reply 413. [PMID: 21438173 DOI: 10.1002/ppul.21382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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