Chronic Chlamydia pneumonia Infection and Risk of Early-Onset Versus Late-Onset Preeclampsia

Preeclampsia is one of the challenges associated with mother and baby health. Preeclampsia and atherosclerosis share certain similarities. Atherosclerosis has been previously linked to chronic Chlamydia pneumoniae infection. This investigation aimed to establish the role of chronic Chlamydia pneumoniae in the development and onset of preeclampsia. The research was conducted from October 1, 2018 to September 30, 2019 in the department of Obstetrics and Gynecology at Al-Yarmouk Teaching Hospital in Baghdad, Iraq. The study included 140 pregnant women divided into two groups: 70 women with early and late-onset preeclampsia and 70 women with late-onset preeclampsia. Group I (early-onset preeclampsia) included 35 singleton pregnant women who developed preeclampsia after 34 weeks with blood pressure>140/90 and proteinuria>1. Late-onset preeclampsia (group II) consisted of 35 singleton pregnant women who developed clinical preeclampsia after 34 weeks of pregnancy, with blood pressure>140/90 and proteinuria +1, and 70 healthy term pregnant women without complications who acted as the control group (Group III). Enzyme-Linked Immunosorbent Assay (ELISA) analyzers were utilized to measure serum Chlamydia pneumoniae IgG levels in all study groups. Women with early-onset preeclampsia had the highest median Chlamydia pneumonia IgG level, 0.3 U/ml, compared to 0.09 U/ml for women with late-onset preeclampsia and 0.19U/ml for healthy term pregnant women without complications; these differences were statistically significant (P=0.001). This study found that the IgG titer for Chlamydia pneumoniae was higher in early-onset preeclampsia than in late-onset preeclampsia and in healthy term pregnancy without complications. This substantial increase was a direct result of the onset of preeclampsia. This provided evidence for the pathophysiological connection between preeclampsia and the reactivation of a chronic or latent infection.

A patient with end-stage renal disease who recovered from coronavirus disease 2019 then received a kidney transplant

Since its emergence in December 2019 many end-stage renal disease (ESRD) patients have been infected with coronavirus disease 2019 (COVID-19). Herein, we describe the case of an ESRD patient who received a kidney transplant after recovering from COVID-19. We described the clinical course of COVID-19 and kidney transplant management, including the patient's symptoms, laboratory results, computed tomography, and antibody profiles. He recovered well, without complications. Chest computed tomography, PCR, and IgG results indicated no recurrence of COVID-19 during the subsequent two weeks. Therefore, kidney transplantation is feasible in an ESRD patient who has recovered from COVID-19, under a normal immunosuppressive regimen.

Rubella immune status of neonates - a window towards seroprevalence among childbearing women

BACKGROUND

When contracted in pregnancy, rubella may cause serious chronic infection of the fetus and development of Congenital Rubella Syndrome. Despite widespread application of rubella vaccination, periodical outbreaks are still being reported worldwide. The aim of this study was to determine rubella seroprevalence and antibody levels in neonates in Serbia as a proxy of maternal serostatus.

METHODS

ELISA based serological testing for rubella was done in 599 neonates treated at the Institute of Neonatology in Belgrade, from January 2010 to December 2011. All individuals with rubella IgG concentration ≥10 IU/ml were considered seropositive for rubella.

RESULTS

The mean age of enrolled neonates was 18 ± 6 days. The overall seroprevalence of rubella IgG antibodies among the tested neonates was 540/599(90.2 %, 95 % CI: 87.5-92.3). Seropositivity rate among sera of the neonates enrolled in 2010 was significantly higher than those collected in 2011 (p < 0.0001). There was no difference in average maternal age, gestational age or frequency of receiving blood products among the two study years. Significant high seropositivity rate was observed among neonates from mother aged >30 as compared to those from mothers aged <20 years (p = 0.02). Significant difference was also found between average IgG titers in the two study years (79 IU/mL in 2010 vs. 46 IU/mL in 2011, p < 0.0001).

CONCLUSION

We report on high rubella seroprevalence among newborns in Serbia, as a proxy of rubella serostatus of childbearing aged women. Notably, declining trend of rubella antibodies toward diminishing titers suggest the importance of sustained rubella serosurvey and antenatal screening at the national level.