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Updates in Congenital Infections: Pathology, Diagnosis, Management and Outcomes

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A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Infectious Diseases".

Deadline for manuscript submissions: closed (1 April 2024) | Viewed by 16838

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Special Issue Editors

Prof. Dr. Danilo Buonsenso

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Guest Editor

Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Campus di Roma, Rome, Italy
Interests: pediatric infectious diseases; global health
Special Issues, Collections and Topics in MDPI journals

Dr. Piero Valentini

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Guest Editor

Department of Woman and Child Health and Public Health, Università Cattolica del Sacro Cuore, Campus di Roma, Rome, Italy
Interests: pediatric infectious diseases; global health

Special Issue Information

Dear Colleagues,

Congenital infections still represent a major burden of morbidity and mortality worldwide. Despite several advances made in the understanding of their aetiology, methods for their optimal management and means for the prevention of several groups of infections are still unknown. Moreover, SARS-CoV-2 has been added to the list of known agents able to infect pregnant women and cross the placenta, causing vertical infections.

The aim of this Special Issue is to link expert and young researchers in the field to share updated perspectives on congenital infections. We are interested in studies discussing epidemiology, diagnostics, and clinical and management implications, as well as social issues related to the topic (including, but not limited to, socially fragile populations).

Dr. Danilo Buonsenso
Dr. Piero Valentini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

congenital infections
pregnant women
newborns
SARS-CoV-2
infections

Published Papers (6 papers)

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Research

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12 pages, 933 KiB

Open AccessArticle

Comparison between Short Therapy and Standard Therapy in Pediatric Patients Hospitalized with Urinary Tract Infection: A Single Center Retrospective Analysis

by Danilo Buonsenso, Giorgio Sodero, Francesco Mariani, Ilaria Lazzareschi, Francesco Proli, Giuseppe Zampino, Luca Pierantoni, Piero Valentini and Claudia Rendeli

Children 2022, 9(11), 1647; https://0-doi-org.brum.beds.ac.uk/10.3390/children9111647 - 28 Oct 2022

Cited by 4 | Viewed by 1986

Abstract

Introduction: There is marked heterogeneity in clinicians’ choice of antibiotic duration for pediatric urinary tract infections (UTIs). Most patients with bacterial UTIs still receive between 7 and 10 days of antibiotics. Prolonged antibiotic exposure drives the emergence of resistance and increases the occurrence of adverse effects. There is increasing evidence that shorter antibiotic regimens may be equally effective compared with longer ones. However, studies evaluating shorter therapies in children hospitalized with urinary tract infections have not yet been performed. Methods: We performed a retrospective study comparing children hospitalized with UTIs treated with a short antibiotic (<7 days) or standard antibiotic treatment. The primary aim of our study was to assess the efficacy of a shorter antibiotic therapy for children with UTIs, compared with an historical group of children treated with a standard 7–14 days course. Results: 112 patients, 46 of which were females (41.1%) with a median age 6 months were enrolled. A total of 33 patients (29.5%) underwent a short therapy. All patients were successfully discharged from the acute episode, independently from antibiotic duration. Short therapy was associated with a lower risk of urinary tract relapse (22 relapses (95.6%) in the standard group, 1 (4.4%) in the short group; OR 0.081; 95%CI 0.01–0.63). Conclusions: Short antibiotic therapy was equivalent to standard duration therapy for the cure of UTIs in hospitalized children and was also associated with a lower rate of recurrences. This study provides the basis for a larger prospective randomized study to address the role of short antibiotic therapies in children with UTIs requiring hospitalization Full article

(This article belongs to the Special Issue Updates in Congenital Infections: Pathology, Diagnosis, Management and Outcomes)

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14 pages, 8010 KiB

Open AccessArticle

Burkholderia cepacia Complex Infections in Urgently Referred Neonates from Syrian Border Regions to a Hospital in Turkey: A Cross-Border Cluster

by Benhur Sirvan Cetin and Ayşen Orman

Children 2022, 9(10), 1566; https://0-doi-org.brum.beds.ac.uk/10.3390/children9101566 - 16 Oct 2022

Cited by 1 | Viewed by 2050

Abstract

Burkholderia cepacia complex (BCC) is a rare cause of sepsis in neonates, but infections are usually severe. It can be encountered unexpectedly when adequate health care is not provided. In this study, 49 neonatal cases with blood culture-proven BCC bacteremia within the first 72 h following admission to the neonatal intensive care unit between June 2017 and December 2018 were retrospectively analyzed in detail. All but one of the cases were born in Jarabulus, Al Bab, or Aleppo in Syria and were referred to Turkey due to urgent medical treatment needs. The rate of BCC bacteremia among the neonates transferred from across the border was 16.1% (48/297). The most common coexisting problems in the cases were multiple congenital malformations (12.2%), gastrointestinal system atresia (8.2%), and congenital heart diseases (4.1%). The median age at the time of their admission in Turkey was three days, and the median length of stay in another center before the referral was 11.5 h. The case fatality rate was 14.3%. In this study, a high rate of BCC infection and associated mortality was seen in neonates referred from cross-border regions. For centers accepting cases from conflict-affected regions, it is crucial to be careful regarding early detection of bacteremia, planning appropriate treatments, and preventing cross-contamination risks within the unit. Full article

(This article belongs to the Special Issue Updates in Congenital Infections: Pathology, Diagnosis, Management and Outcomes)

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11 pages, 1014 KiB

Open AccessArticle

Neurological Short-Term Outcomes of a Cohort of Children Born to Zika Virus-Infected Mothers in Barcelona

by Natàlia Romaní, Maria Pieras, Marie Antoinette Frick, Elena Sulleiro, Carlota Rodó, Aroa Silgado, Anna Suy, Maria Espiau, Claire Thorne, Carlo Giaquinto, Ana Felipe-Rucián, Pere Soler-Palacín and Antoni Soriano-Arandes

Children 2022, 9(10), 1537; https://0-doi-org.brum.beds.ac.uk/10.3390/children9101537 - 09 Oct 2022

Cited by 1 | Viewed by 1950

Abstract

Zika virus (ZIKV) is a vector-borne flavivirus with a known teratogenic effect, yet the full spectrum has not been delineated. Studies on endemic areas tried to characterize the clinical outcomes of ZIKV intrauterine exposure. We aimed to describe early neurodevelopmental outcomes on prenatally ZIKV-exposed children in a non-endemic ZIKV area. This is a prospective observational cohort study conducted from May 2016 to December 2021 at Hospital Universitari Vall d’Hebron in Barcelona, Catalonia, Spain. We monitored for up to 24 months 152 children extracted from a pregnant women cohort with suspected ZIKV infection; eleven women (11/150; 7.3%) fulfilled the criteria for a confirmed ZIKV infection. Among the 152 children included, we describe two cases of congenital ZIKV syndrome (CZS) born from women with a confirmed ZIKV infection. Additionally, we describe five cases of other potentially ZIKV-related outcomes (OPZROs), all with normal birth cranial circumference and born to women with probable ZIKV infection. The low exposed prevalence of adverse outcomes in asymptomatic children at birth in a non-endemic area suggests that close follow-up should be addressed by primary care pediatricians instead of pediatric specialists. Further studies are needed to assess the effects of ZIKV intrauterine exposure beyond two years of life. Full article

(This article belongs to the Special Issue Updates in Congenital Infections: Pathology, Diagnosis, Management and Outcomes)

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13 pages, 1270 KiB

Open AccessArticle

Association between Pediatric Adenovirus Infection and Type 1 Diabetes

by Amany A. Arafa, Adel Abdel-Moneim, Rehab G. Khalil, Waled M. El-Senousy, Mahmoud M. Kamel, Dalia Y. Kadry, Gamal Allam and Ahmed S. Abdel-Moneim

Children 2022, 9(10), 1494; https://0-doi-org.brum.beds.ac.uk/10.3390/children9101494 - 29 Sep 2022

Cited by 1 | Viewed by 1568

Abstract

Background: Viruses are among the inducers of type 1 diabetes (T1D) as they are implicated in the initiation of β-cell destruction. This study aimed to explore the link between adenoviruses’ infection, inflammatory biomarkers, and the development of T1D. Methods: The study population included 80 children with T1D and 40 healthy controls (2–16 years old). The T1D group was further clustered into two groups according to time of T1D diagnosis: a group of children who were diagnosed during the first year of life and a second group who were diagnosed after the first year of life. Adenovirus DNA, anti-adenovirus IgG, cytokines, and lipid profiles were screened in the different groups. The results were statistically assessed using one-way analysis of variance (ANOVA) and LSD t-test. Results: Positive adenovirus PCR was detected in 2.5% and 20% of normal and T1D children, respectively. Moreover, the positive PCR results for adenovirus were found significantly higher in the T1D group, who were diagnosed during the first year of life (33.4%), in comparison to those diagnosed after the first year of life (12%). Anti-adenoviruses IgG was found in 12.5% and 40% of healthy controls and diabetic children, respectively. Seropositive results were found to be higher in newly diagnosed children (46.7%) in comparison to those previously diagnosed with T1D (36%). Body mass index (BMI), IFN-γ, IL-15, adiponectin, lipid profile, and microalbuminuria were significantly increased in T1D adenoviruses-positive children compared to children who were negative for adenoviruses. Conclusions: Adenovirus infection could be among the contributing risk factors and may play a role in the induction of T1D in children. Full article

(This article belongs to the Special Issue Updates in Congenital Infections: Pathology, Diagnosis, Management and Outcomes)

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8 pages, 233 KiB

Open AccessArticle

Congenital CMV, Lights and Shadows on Its Management: The Experience of a Reference Center in Northern Italy

by Valeria Rubinacci, Mara Fumagalli, Giulia Meraviglia, Laura Gianolio, Anna Sala, Marta Stracuzzi, Anna Dighera, Gian Vincenzo Zuccotti and Vania Giacomet

Children 2022, 9(5), 655; https://0-doi-org.brum.beds.ac.uk/10.3390/children9050655 - 03 May 2022

Cited by 4 | Viewed by 2008

Abstract

Congenital cytomegalovirus infection (cCMV) is the most common congenital viral infection, with a consistent rate of morbidity, mortality, and long-term sequelae, especially in the case of late diagnosis. Nevertheless, a universal screening for CMV is not currently recommended, and global awareness about this infection, as well as accurate and shared indications on follow-up and treatment, are still lacking. We reviewed data about 59 suspect cCMV cases who referred to our center from 2014 to 2021. We report 41 cases of confirmed cCMV diagnosed at birth, with clinical or radiological abnormalities in 36.6% of them. Other five patients received a late diagnosis and all presented neurological impairment. Twelve patients received therapy with Valganciclovir within the first month of life, with favorable outcome in nine cases. Therapy after the first month of life was attempted in four patients, with improvement in one case. The overall awareness about cCMV infection was 32.6%. Considering our population, maternal serological screening followed by targeted testing of neonates could be an effective strategy. Some aspects of cCMV infection management should be further investigated, such as indication of treatment after the first month of life or in asymptomatic patients. Awareness about the infection should be improved to implement preventive strategies. Full article

(This article belongs to the Special Issue Updates in Congenital Infections: Pathology, Diagnosis, Management and Outcomes)

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Review

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23 pages, 29084 KiB

Open AccessEditor’s ChoiceReview

From Fetal to Neonatal Neuroimaging in TORCH Infections: A Pictorial Review

by Giulia Lucignani, Alessia Guarnera, Maria Camilla Rossi-Espagnet, Giulia Moltoni, Amanda Antonelli, Lorenzo Figà Talamanca, Chiara Carducci, Francesca Ippolita Calo Carducci, Antonio Napolitano, Carlo Gandolfo, Francesca Campi, Cinzia Auriti, Cecilia Parazzini and Daniela Longo

Children 2022, 9(8), 1210; https://0-doi-org.brum.beds.ac.uk/10.3390/children9081210 - 11 Aug 2022

Cited by 6 | Viewed by 6268

Abstract

Congenital infections represent a challenging and varied clinical scenario in which the brain is frequently involved. Therefore, fetal and neonatal neuro-imaging plays a pivotal role in reaching an accurate diagnosis and in predicting the clinical outcome. Congenital brain infections are characterized by various clinical manifestations, ranging from nearly asymptomatic diseases to syndromic disorders, often associated with severe neurological symptoms. Brain damage results from the complex interaction among the infectious agent, its specific cellular tropism, and the stage of development of the central nervous system at the time of the maternal infection. Therefore, neuroradiological findings vary widely and are the result of complex events. An early detection is essential to establishing a proper diagnosis and prognosis, and to guarantee an optimal and prompt therapeutic perinatal management. Recently, emerging infective agents (i.e., Zika virus and SARS-CoV2) have been related to possible pre- and perinatal brain damage, thus expanding the spectrum of congenital brain infections. The purpose of this pictorial review is to provide an overview of the current knowledge on fetal and neonatal brain neuroimaging patterns in congenital brain infections used in clinical practice. Full article

(This article belongs to the Special Issue Updates in Congenital Infections: Pathology, Diagnosis, Management and Outcomes)

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