IMPORTANCE The procalcitonin (PCT) assay is an accurate screening test for identifying invasive bacterial infection (IBI); however, data on the PCT assay in very young infants are insufficient. OBJECTIVE To assess the diagnostic characteristics of the PCT assay for detecting serious bacterial infection (SBI) and IBI in febrile infants aged 7 to 91 days. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study that included infants aged 7 to 91 days admitted for fever to 15 French pediatric emergency departments was conducted for a period of 30 months (

Children with IPD should undergo immunological investigations, particularly those aged >2 years, as PIDs may be discovered in up to 26% of cases.

Neonates with intrauterine growth restriction (IUGR) are prone to suffer from digestive diseases. Using neonatal pigs with IUGR, we tested the hypothesis that IUGR may induce alterations in the developmental pattern of intestinal barrier and thereby may be responsible for IUGR-associated increased morbidity. Piglets with a birth weight near the mean birth weight (+/-0.5 SD) were identified as normal birth weight (control) and piglets with a mean -2 SD lower birth weight (-30%) were defined as piglets with IUGR. The developmental pattern of intestinal structure, transcriptomic profile, and bacterial colonization was investigated from birth to d 5 postnatal. At birth, intestinal weight and length, ileal and colonic weight per unit of length, and villous sizes were lower (P < 0.05) in piglets with IUGR than in same-age control piglets. These IUGR-induced intestinal alterations further persisted, although they were less marked at d 5. Counts of adherent bacteria to ileal and colonic mucosa were greater (P < 0.05) in 2-d-old piglets with IUGR than in same-age control piglets. Dynamic analyses of the transcriptomic profile of the intestine revealed molecular evidence of IUGR-induced intestinal growth impairment that may result from a change in the cell proliferation-apoptosis balance during the first days of life, while a protective process would occur later on. In addition, changes in the expression of several genes suggest a pivotal role of both glucocorticoids and microbiota in driving IUGR intestinal development during the neonatal period.

Background: Neonates born after intrauterine growth restriction (IUGR) show higher mortality and morbidity and greater feeding problems postnatally. Objectives: We tested the hypothesis that IUGR affects the intestinal structure, function, microbiology and proinflammatory cytokine expression during the immediate neonatal period. Methods: We firstly compared organ weights and intestinal digestive enzyme activities between control and IUGR newborn piglets delivered by cesarean section at full term or prematurely (91% gestation). Next, we compared intestinal structure, function and microbiota in spontaneously delivered control and IUGR term piglets during the period 0–5 days of age, when intestinal adaptation is normally very rapid. Results: At the time of birth, organ weights and intestinal enzyme activities were not notably affected by IUGR, neither for preterm nor term pigs, except that IUGR was associated with a relatively long and thin intestine. Between birth and 5 days of age, the normal developmental pattern in the ileum and colon appeared to be delayed in term IUGR piglets, as indicated by lower ileal density (weight per unit length) and villous area (–20 to –30%), higher expression of the peptide transporter PEPT1 (+150% on day 2) and enhanced bacterial adhesion and translocation during days 2–5 (all p < 0.05). Further, expression of the proinflammatory cytokine IL-6 was modified in the intestine of term IUGR piglets at birth without any change in IL-1β. Conclusion: IUGR is associated with a longer and thinner intestine at birth, and during the immediate postnatal period, intestinal adaptation and bacterial colonization are altered in IUGR piglets born at full term.