Clinical and Epidemiologic Characteristics of Viral Infections in a Neonatal Intensive Care Unit During a 12-Year Period

Verboon-Maciolek, Malgorzata A.; Krediet, Tannette G.; Gerards, L. J.; Fleer, A.; Loon, Ton M van

doi:10.1097/01.inf.0000180471.03702.7f

Cited by 116 publications

(81 citation statements)

References 27 publications

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“…There are other viruses associated with congenital infections, such as rubella virus, cytomegalovirus, lymphocytic choriomeningitis virus, and human immunodeficiency virus, for example. Additional seasonal viruses, including influenza virus, respiratory syncytial virus (RSV), adenoviruses, rhinoviruses, and rotaviruses, have been identified in hospitalized neonates, related primarily to horizontal transmission (41). However, these pathogens are not typically associated with an EOS presentation.…”

Section: Pathogensmentioning

confidence: 99%

Early-Onset Neonatal Sepsis

et al. 2014

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SUMMARY Early-onset sepsis remains a common and serious problem for neonates, especially preterm infants. Group B streptococcus (GBS) is the most common etiologic agent, while Escherichia coli is the most common cause of mortality. Current efforts toward maternal intrapartum antimicrobial prophylaxis have significantly reduced the rates of GBS disease but have been associated with increased rates of Gram-negative infections, especially among very-low-birth-weight infants. The diagnosis of neonatal sepsis is based on a combination of clinical presentation; the use of nonspecific markers, including C-reactive protein and procalcitonin (where available); blood cultures; and the use of molecular methods, including PCR. Cytokines, including interleukin 6 (IL-6), interleukin 8 (IL-8), gamma interferon (IFN-γ), and tumor necrosis factor alpha (TNF-α), and cell surface antigens, including soluble intercellular adhesion molecule (sICAM) and CD64, are also being increasingly examined for use as nonspecific screening measures for neonatal sepsis. Viruses, in particular enteroviruses, parechoviruses, and herpes simplex virus (HSV), should be considered in the differential diagnosis. Empirical treatment should be based on local patterns of antimicrobial resistance but typically consists of the use of ampicillin and gentamicin, or ampicillin and cefotaxime if meningitis is suspected, until the etiologic agent has been identified. Current research is focused primarily on development of vaccines against GBS.

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Section: Pathogensmentioning

confidence: 99%

Early-Onset Neonatal Sepsis

et al. 2014

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“…Therefore, due to the large number and types of viruses, identifying and deciphering the mechanism by which viral infection induces seizures have been challenging. For example, two members of the family Picornaviridae, Enterovirus (EV) and Parechovirus (PeV), have been shown to induce seizures in infected children; however, the available diagnostic tests for EVs do not detect PeVs (2,3). A recent retrospective study, using pediatric cerebrospinal fluid samples previously screened for EV, demonstrated that the inclusion of a novel PeV-specific PCR assay led to a 31% increase in the detection of viruses causing virally induced CNS symptoms and neonatal sepsis (4).…”

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confidence: 99%

Infiltrating Macrophages Are Key to the Development of Seizures following Virus Infection

Cusick

Libbey

Patel

et al. 2013

J Virol

100

173

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b Viral infections of the central nervous system (CNS) can trigger an antiviral immune response, which initiates an inflammatory cascade to control viral replication and dissemination. The extent of the proinflammatory response in the CNS and the timing of the release of proinflammatory cytokines can lead to neuronal excitability. Tumor necrosis factor alpha (TNF-␣) and interleukin-6 (IL-6), two proinflammatory cytokines, have been linked to the development of acute seizures in Theiler's murine encephalomyelitis virus-induced encephalitis. It is unclear the extent to which the infiltrating macrophages versus resident CNS cells, such as microglia, contribute to acute seizures, as both cell types produce TNF-␣ and IL-6. In this study, we show that following infection a significantly higher number of microglia produced TNF-␣ than did infiltrating macrophages. In contrast, infiltrating macrophages produced significantly more IL-6. Mice treated with minocycline or wogonin, both of which limit infiltration of immune cells into the CNS and their activation, had significantly fewer macrophages infiltrating the brain, and significantly fewer mice had seizures. Therefore, our studies implicate infiltrating macrophages as an important source of IL-6 that contributes to the development of acute seizures.

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“…Herpes simplex virus, cytomegalovirus, varicella-zoster virus, Epstein-Barr virus, human herpesvirus 6, and Kaposi's sarcoma-associated herpesvirus (KSHV) have all been associated with respiratory diseases (7,10,30,33,42,46). Much of our understanding of immune responses to viral infection of the respiratory tract comes from experimental animal models.…”

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confidence: 99%

Type I Interferon Inhibition and Dendritic Cell Activation during Gammaherpesvirus Respiratory Infection

Weslow-Schmidt

Jewell

Mertz

et al. 2007

J Virol

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The respiratory tract is a major mucosal site for microorganism entry into the body, and type I interferon (IFN) and dendritic cells constitute a first line of defense against viral infections. We have analyzed the interaction between a model DNA virus, plasmacytoid dendritic cells, and type I IFN during lung infection of mice. Our data show that murine gammaherpesvirus 68 (␥HV68) inhibits type I IFN secretion by dendritic cells and that plasmacytoid dendritic cells are necessary for conventional dendritic cell maturation in response to ␥HV68. Following ␥HV68 intranasal inoculation, the local and systemic IFN-␣/␤ response is below detectable levels, and plasmacytoid dendritic cells are activated and recruited into the lung with a tissue distribution that differs from that of conventional dendritic cells. Our results suggest that plasmacytoid dendritic cells and type I IFN have important but independent roles during the early response to a respiratory ␥HV68 infection. ␥HV68 infection inhibits type I IFN production by dendritic cells and is a poor inducer of IFN-␣/␤ in vivo, which may serve as an immune evasion strategy.Respiratory viral infections are the leading cause of acute illnesses worldwide, and several members of the herpesvirus family are responsible for severe pneumonia in neonates and immunocompromised patients (52). Herpes simplex virus, cytomegalovirus, varicella-zoster virus, Epstein-Barr virus, human herpesvirus 6, and Kaposi's sarcoma-associated herpesvirus (KSHV) have all been associated with respiratory diseases (7,10,30,33,42,46). Much of our understanding of immune responses to viral infection of the respiratory tract comes from experimental animal models. Murine gammaherpesvirus 68 (␥HV68) is structurally and biologically similar to the human gammaherpesviruses Epstein-Barr virus and KSHV (16,49,50), and it has become a useful in vivo model of herpesvirus infection. Intranasal infection of mice with ␥HV68 causes an acute respiratory infection that is rapidly resolved and followed by the establishment of splenic latency mainly in the B-cell compartment (16, 34). Analogous to KSHV (35,38,41), ␥HV68 also infects dendritic cells, a process that may act as a mechanism of immune evasion (18,20).Plasmacytoid dendritic cells are professional type I interferon (IFN)-producing cells that quickly respond to most viruses by secreting large amounts of type I IFNs (28). Type I IFN signaling is important for the control of acute ␥HV68 infection (17, 51). In addition, plasmacytoid dendritic cells secrete cytokines and interact with conventional dendritic cells and T cells (28) and are critical for the defense against parenteral and mucosal infections (1,13,25,29). Although plasmacytoid dendritic cells have been detected in the lungs (12,14) and have been shown to prevent the development of allergic asthma, we have limited information regarding their role in the antiviral response of the respiratory tract. This is of special importance because the lung is the largest epithelial surface in the body and constit...

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Clinical and Epidemiologic Characteristics of Viral Infections in a Neonatal Intensive Care Unit During a 12-Year Period

Cited by 116 publications

References 27 publications

Early-Onset Neonatal Sepsis

Early-Onset Neonatal Sepsis

Infiltrating Macrophages Are Key to the Development of Seizures following Virus Infection

Type I Interferon Inhibition and Dendritic Cell Activation during Gammaherpesvirus Respiratory Infection

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