Neonatal infections: Case definition and guidelines for data collection, analysis, and presentation of immunisation safety data (original) (raw)
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Vaccine, 2016
More than 40% of all deaths in children under 5 years of age occur during the neonatal period: the first month of life. Immunization of pregnant women has proven beneficial to both mother and infant by decreasing morbidity and mortality. With an increasing number of immunization trials being conducted in pregnant women, as well as roll-out of recommended vaccines to pregnant women, there is a need to clarify details of a neonatal death. This manuscript defines levels of certainty of a neonatal death, related to the viability of the neonate, who confirmed the death, and the timing of the death during the neonatal period and in relation to immunization of the mother.
The contribution of infections to neonatal deaths in England and Wales
2011
Hib-primed but MenC-naive toddlers (N ϭ 433) were randomized to receive 1 dose of Hib-MenC-TT or separate Hib-TT and MenC-CRM 197 vaccines. One month later, noninferiority was demonstrated for serum bactericidal anti-MenC antibodies (rSBA) and Hib antipolyribosylribitol phosphate (PRP) antibodies; Ͼ99% in both groups had rSBA titer Ն8 or anti-PRP concentration Ն0.15 g/mL. After 12 months, rSBA titer Ն8 persisted in 86.7% and 76.4%, and anti-PRP concentration Ն0.15 g/mL persisted in 98.8% and 100% of children, respectively.
Journal of Obstetric, Gynecologic, <html_ent glyph="@amp;" ascii="&"/> Neonatal Nursing, 1987
The changing epidemiology of neonatal infections manifested in the first few weeks of life is described. The six infections discussed are herpes. hepatitis 6, chtamydial infection, infection due to the group B streptococcus, gonococcal disease, and acquired immunodeficiency syndrome. Nursing actlons to prevent the spread of these diseases are described, with particular emphasis on the importance of body substance precautions for all neonates.
Serious bacterial infections in neonates: improving reporting and case definitions
International health, 2017
Neonatal infections affect about 7 million neonates causing over 600 000 deaths every year. Estimating the burden is challenging as there are multiple reporting criteria and definitions for serious bacterial infections in neonates. Essential criteria for reporting serious neonatal bacterial infections have recently been published as the STROBE-NI checklist and, in the context of maternal vaccination, definitions have been published by the Brighton Collaboration Global Alignment of Immunization safety Assessment in pregnancy (GAIA) project. Standardisation of reporting criteria is essential to allow data comparability. This an important step in providing a clearer picture of the burden of serious bacterial infections in neonates and a welcome progress for guiding new investments in interventions.
4th Congress of Joint European Neonatal Societies: Infection, Inflammation and Immunology
Pediatric Research
Background: Neonatal nosocomial infections (NNI) may lead to increased risk of morbidity, mortality and increased hospital stay. Therefore it is critical to monitor and prevent NNI. Surveillance of NNI is an indispensable tool in this process. The objective of this review is to provide an overview of surveillance case definitions, surveillance methods and outcome measures for NNI. Methods: A scoping review was performed according to the guidelines of the Briggs institute. Only results for the subtypes hospital acquired pneumonia" (HAP) en "ventilator acquired pneumonia" (VAP) are presented here. Results: Full text screening was performed on n = 294 of 16.067 articles of which n = 86 were included. HAP: Surveillance case definitions were provided in 17 studies: 5 were according to CDC, 3 according to NEO-KISS, 4 used other sources and 5 were formulated by researchers (Table1). Manual surveillance was used in six; semi-automatic in two studies. Surveillance method was not reported in 53%. Outcome measures were: number of episodes (1x); number of neonates with HAP (11x); days with HAP/per 1000 in hospital days (3x). VAP: Surveillance case definitions were provided in 74 studies: 49 were according to CDC, 2 according to NEO-KISS, 18 used other sources and 5 were formulated by researchers. Manual surveillance was used in 28; semi-automatic in 17 studies. Surveillance method was not reported in 39%. Outcome measures were: days with VAP/per 1000 ventilation days (33x); number of neonates with VAP (23x); % neonates with VAP (8x); number of episodes (2x); cases of VAP/per 100 mechanically ventilated neonates (1x). Conclusion: There is a serious lack of reporting and an extensive variation in surveillance case definitions, surveillance methods and outcome measures for neonatal HAP and VAP. This makes it impossible to compare results from different studies. A possible solution for this is a core outcome and minimum reporting set developed though consensus. By using a consistent, pragmatic surveillance method for neonatal HAP and VAP, as well as other subtypes of NNI, we will be able to study the true burden in terms of neonatal outcome and costs, as well as the effects of preventive measures.
Definite bacterial infection in recently vaccinated febrile infants
Journal of Paediatrics and Child Health, 2020
Aim: There is insufficient evidence regarding the best approach to evaluating recently vaccinated (RV) infants presenting to the paediatric emergency department with fever. The aim of the present study is to determine the prevalence of bacterial infections in infants presenting with fever within 72 h after vaccination. Methods: We retrospectively reviewed the electronic medical record of infants aged between 6 and 12 weeks who presented with a fever ≥38 C to the emergency department from January 2016 to December 2018. Febrile infants who were vaccinated within 72 h prior to their emergency department presentation were matched to those who had not received their vaccines in the previous 72 h. Definite serious bacterial infection was diagnosed based on culture results. Results: A total of 198 infants (age: 9 AE 1.84 weeks, male: 119 (60.1%)) were enrolled in this study. Overall, 60 of 138 (30.3%) had received their vaccines within the previous 72 h. The prevalence of bacterial infection in RV infants was 5% compared to 15.2% in non-RV infants (P = 0.056). Interestingly, all vaccinated infants who had proven bacterial infection presented to the emergency department with fever within 24 h of vaccination, and all bacterial infections in that group were urinary tract infections. Conclusions: The prevalence of bacterial infection among non-RV febrile infants is relatively higher than those RV. However, fever should not be attributed only to the vaccinations, and all febrile RV infants should be carefully evaluated, and at least urine testing should be performed regardless of the time of vaccination.