Although Staphylococcus aureus is a major cause of outbreaks in neonatal intensive care units (NICUs), there are no studies on the epidemiology of S. aureus isolates responsible for infection in Portuguese NICUs. Between July 2005 and December 2007, a total of 54 methicillin susceptible S. aureus (MSSA) isolates were recovered from 16 infected infants, parents, health care workers (HCWs), and the environment in a level III NICU. Isolates were characterized by pulsed-field gel electrophoresis (PFGE), spa typing, and multilocus sequence typing. Virulence determinants were detected by multiplex polymerase chain reaction. Three major MSSA clones were endemic in the NICU, representing 70% (n = 38) of the isolates: PFGE type A-ST5 (n = 17); type B-ST30 (n = 12); and type C-ST1 (n = 9). Leukotoxins and hemolysins were present in all isolates, although none of them carried PVL. HCWs, plastic folders protecting clinical files, and mothers' nipples were identified as potential reservoirs and/or vehicles of dissemination of S. aureus. Consequently, additional infection control measures were implemented in this NICU.
This study assesses the epidemiology of invasive fungal infection (IFI) in Portuguese Neonatal Intensive Care Units (NICUs) and compares the effectiveness and safety of antifungal therapies. A survey concerning the period 2005-2010 was carried out in NICUs of Greater Lisbon. Among 10 473 admitted neonates, 44 cases were identified, 29 among extreme low birth weight neonates (65.9%). Cumulative incidence rate was 0.42% (95%CI 0.309-0.559). A central vascular catheter was present before IFI in all cases. Candida albicans and Candida parapsilosis were the most frequent isolates. The initial antifungic was fluconazole in 22 cases and liposomal amphotericin B (L-AmB) in 18. Therapy was switched in 10 patients on fluconazole and 3 on L-AmB. Case fatality rate was 11.4% (95%CI 4.39-23.91). No serious adverse drugs reactions (SADRs) or clinical side effects were observed. The knowledge of the local epidemiology helps to identify adequate prophylactic and treatment strategies.
Introduction: Guidance for pregnant women has been particularly problematic since the beginning of the COVID-19 pandemic. The aim of this study was to describe the characteristics and outcomes of pregnant women with SARS-CoV-2 infection and their newborns.Material and Methods: Case review of clinical records of pregnant women with SARS-CoV-2 infection admitted for delivery and their newborns from April to December 2020 at a hospital in the Lisbon metropolitan area.Results: From 1755 births, 81 (4.6%) were from SARS-CoV-2 positive mothers. Most (83.9%) were term newborns. Almost 16% were preterm, while there was an overall prematurity rate of 9.9%. Most women (88.6%) were asymptomatic. Rooming-in occurred in 80.8% cases and 19.2% newborns were admitted to the Neonatal Intensive Care Unit. From the total, 56.7% newborns were breastfed from birth and 43% had mixed feeding. None of the newborns had symptoms related to COVID-19 infection, and all had negative rt-PCR for SARS-CoV-2 at birth and at 48 hours of life. The majority (85.2%) was discharged home with their mothers.Discussion: Pregnant women with COVID-19 have shown immune characteristics resembling healthy pregnancies, and it is not yet clear if SARS-CoV-2 can be vertically transmitted. Recent updates on neonatal guidance now recommend rooming-in and support the relative safety of breastfeeding.Conclusion: This study supports other published articles regarding maternal and neonatal outcomes of SARS-CoV-2 infected pregnant women, including the absence of short-term adverse outcomes with rooming-in and breastfeeding.
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