Posts filed under ‘Infecciones en embarzadas’

Respiratory Virus Infection During Pregnancy: Does It Matter?

The Journal of Infectious Diseases August 15, 2018 V.218 N.4 P.512-515


Janet A Englund; Helen Y Chu





August 13, 2018 at 6:24 pm

Protecting Mothers and Babies — A Delicate Balancing Act

N Engl J of Medicine July 24, 2018


Protecting Mothers and Babies — A Delicate Balancing Act

S.A. Rasmussen, W. Barfield, and M.A. Honein

More than 50 years ago, an epidemic of serious birth defects caused by prenatal exposure to thalidomide shattered the prevailing notion that the placenta served as a barrier against damaging influences and led to recognition that exposures during pregnancy can result in harm to a developing fetus. Since that time, ensuring that a pregnant woman has access to potentially lifesaving treatments while safeguarding her fetus has become a delicate balancing act, one that requires a careful evaluation of risks and benefits to both the mother and her fetus…






N Engl J of Medicine July 24, 2018


Neural-Tube Defects with Dolutegravir Treatment from the Time of Conception

  1. Zash, J. Makhema, and R.L. Shapiro

Since August 2014, the Botswana Harvard AIDS Institute Partnership has conducted birth outcome surveillance at eight government hospitals throughout Botswana. A primary ongoing aim of the surveillance is to evaluate the prevalence of neural-tube defects associated with exposure to antiretroviral drugs from the time of conception (the risk period for neural-tube defects ends approximately 28 days after conception). At each site, trained government midwives perform surface examinations of consecutive live-born and stillborn infants who are born in the hospital to women infected with human immunodeficiency virus (HIV) and to women without HIV infection. As part of …



July 24, 2018 at 11:44 am

Diagnostic Performance of a Molecular Test versus Clinician Assessment of Vaginitis

Clin. Microbiol. June 2018 56:13 e00252-18

Jane R. Schwebke, Charlotte A. Gaydos, Paul Nyirjesy, Sonia Paradis, Salma Kodsi, and Charles K. Cooper

Vaginitis is a common complaint, diagnosed either empirically or using Amsel’s criteria and wet mount microscopy. This study sought to determine characteristics of an investigational test (a molecular test for vaginitis), compared to reference, for detection of bacterial vaginosis, Candida spp., and Trichomonas vaginalis. Vaginal specimens from a cross-sectional study were obtained from 1,740 women (≥18 years old), with vaginitis symptoms, during routine clinic visits (across 10 sites in the United States).

Specimens were analyzed using a commercial PCR/fluorogenic probe-based investigational test that detects bacterial vaginosis, Candida spp., and Trichomonas vaginalis. Clinician diagnosis and in-clinic testing (Amsel’s test, potassium hydroxide preparation, and wet mount) were also employed to detect the three vaginitis causes.

All testing methods were compared to the respective reference methods (Nugent Gram stain for bacterial vaginosis, detection of the Candida gene its2, and Trichomonas vaginalis culture). The investigational test, clinician diagnosis, and in-clinic testing were compared to reference methods for bacterial vaginosis, Candida spp., and Trichomonas vaginalis.

The investigational test resulted in significantly higher sensitivity and negative predictive value than clinician diagnosis or in-clinic testing. In addition, the investigational test showed a statistically higher overall percent agreement with each of the three reference methods than did clinician diagnosis or in-clinic testing.

The investigational test showed significantly higher sensitivity for detecting vaginitis, involving more than one cause, than did clinician diagnosis. Taken together, these results suggest that a molecular investigational test can facilitate accurate detection of vaginitis.



June 12, 2018 at 7:34 am

Respiratory Syncytial Virus During Pregnancy

Clinical Infectious Diseases June 1, 2018 V.66 N.11 P.1666–1667

Fernando P Polack

Fundacion INFANT, Buenos Aires, Argentina

Correspondence: F. P. Polack, Fundacion INFANT, Gavilan 94, Buenos Aires (1406), Argentina (

Respiratory syncytial virus (RSV) is the main viral cause of hospitalization in infants and young children worldwide [1]. More than 3 million severe cases and close to 100 000 pediatric deaths every year, half of them at home, demand effective interventions to mitigate disease burden [1]. Addressing this challenge is not easy, however, in part because more than 90% of severe cases and 99% of fatalities due to RSV occur in the developing world [1]. In fact, severe cases in industrialized countries almost exclusively affect high-risk groups that represent only a subset of those burdened by serious illness in developing nations. Congenital heart disease, neuromuscular disorders, chronic lung illness, and/or Down syndrome are almost ubiquitous in fatal cases in industrialized countries [2]. On the other hand, secondary bacterial infections and …



June 10, 2018 at 7:19 pm

Journal of Clinical Microbiology April 2018 V.56  N.4

Diagnostic Testing for Zika Virus: a Postoutbreak Update

Elitza S. Theel and D. Jane Hata

Desde la aparición y diseminación del virus del Zika (ZIKV) a finales de 2015, nuestra comprensión de la biología, la transmisión, las enfermedades clínicas y las posibles secuelas asociadas con la infección se ha ampliado notablemente.

En los últimos 2 años, el número de pruebas diagnósticas para ZIKV aumentó de ninguna en 2015 a 5 pruebas serológicas y 14 ensayos moleculares en 2017, todas con autorización de uso de emergencia otorgada a través de la Administración de Alimentos y Medicamentos de EEUU (FDA).

Proporcionamos una actualización sobre ZIKV, abordando lo que hemos aprendido colectivamente desde que comenzó el brote, incluido un resumen de los ensayos de diagnóstico actualmente disponibles para este virus.



March 27, 2018 at 8:25 am

Protective Effect of Maternal Influenza Vaccination on Influenza in Their Infants: A Prospective Cohort Study

Journal of Infectious Diseases March 15, 2018 V.217 N.6

Satoko Ohfuji; Masaaki Deguchi; Daisuke Tachibana; Masayasu Koyama; Tetsu Takagi …

Este estudio prospectivo de cohortes mostró que la efectividad de la vacunación prenatal y posparto de la influenza para prevenir la influenza entre sus bebés fue del 61% y 53%, respectivamente. La vacunación contra la influenza materna durante el período prenatal o posparto tuvo efectos beneficiosos para proteger a los bebés de la influenza.



Infants <6 months of age are too young to receive influenza vaccine, despite being at high risk for severe influenza-related complications.


To examine the effectiveness of maternal influenza vaccination in preventing influenza in their infants, we conducted a prospective cohort study of 3441 infants born at participating hospitals before the 2013–2014 influenza season. At the time of recruitment, their mothers completed a questionnaire about influenza vaccination status for the 2013–2014 season. A follow-up survey was conducted after the end of the 2013–2014 season to collect information regarding influenza diagnosis and hospitalization among infants.


During the 2013–2014 influenza season, 71 infants (2%) had influenza diagnosed, and 13 infants (0.4%) were hospitalized with influenza. Maternal influenza vaccination (especially prenatal vaccination) decreased the odds of influenza among infants. The effectiveness of prenatal vaccination was 61% (95% confidence interval, 16%–81%), whereas that of postpartum vaccination was 53% (−28%–83%). Although maternal influenza vaccination was also associated with a decreased odds of influenza-related hospitalization among infants, vaccine effectiveness (73%) did not reach statistical significance, owing to the limited number of infants hospitalized because of influenza.


The present findings indicated that pregnant women and postpartum women should receive influenza vaccination to protect their infants.



March 25, 2018 at 11:41 am

Maternal colonization or infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae in Africa: A systematic review and meta-analysis

International Journal of Infectious Diseases November 2017 V.64 N. P.58–66

Andre N.H. Bulabula, Angela Dramowski, Shaheen Mehtar


  • The prevalence of colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) in pregnant and/or post-partum women in Africa is 17% (95% confidence interval 10–23%).
  • The pooled proportions from reviewed studies suggest a greater proportion of ESBL-E colonization in pregnant women compared to post-partum women.
  • The rate of maternal colonization with ESBL-E is greater in community settings than in hospital settings.
  • The most frequently reported ESBL-encoding gene in Africa is CTX-M.


To summarize published studies on the prevalence of and risk factors for maternal bacterial colonization and/or infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) in pregnant and/or post-partum women in Africa.


A systematic review was conducted using the PubMed, Scopus, and Google Scholar databases. Bibliographies of included eligible studies were manually searched to identify additional relevant articles. No language restriction was applied. The timeframe of the search included all records from electronic database inception to July 15, 2017. A random-effects meta-analysis was performed to summarize the prevalence and the 95% confidence intervals (CI) of ESBL-E colonization or infection in pregnant or post-partum women in Africa. The meta-analysis was conducted using STATA IC 13.1 software and the metaprop function/plugin.


Ten studies (seven on pregnant women and three on post-partum women) were included, documenting a 17% prevalence of maternal colonization with ESBL-E in Africa (95% CI 10–23%). The prevalence of ESBL-E in community isolates exceeded that in isolates from the hospital setting (22% vs. 14%). The most frequently reported ESBL-encoding gene was CTX-M (cefotaxime hydrolyzing capabilities). Data on risk factors for maternal ESBL-E colonization and infection are very limited.


The prevalence of colonization and/or infection with ESBL-E in pregnant and post-partum women in Africa exceeds that reported from high- and middle-income settings, representing a risk for subsequent neonatal colonization and/or infection with ESBL-E.



February 9, 2018 at 1:21 pm

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