Rhizobium radiobacter (Agrobacterium radiobacter) is an aerobic Gram-negative rod belonging to Agrobacterium genus, a group of phytopathogenic bacteria present in the soil that has been implicated in human opportunistic infections. We report a clinical case of bacterial peritonitis in a 5-year-old child with chronic renal disease in peritoneal dialysis, who had a history of direct soil contact identified. The infection was treated with ceftazidime and piperaciline+tazobactam without relapses or the need to remove the peritoneal dialysis catheter.

Joubert syndrome is a rare disorder, usually autosomal recessive, with a prevalence of 1:80 000 to 1:100 000. This disease presents most commonly as breathing irregularities, although the two major clinical criteria are hypotonia and developmental delay, sometimes associated with ocular movement abnormalities. The severity of the presentation varies, ranging from mild cases with normal intelligence to severe developmental delays associated with early death. We report a case of a newborn who presented to the emergency department for absent ocular fixation and torsional nystagmus without other neurological abnormalities. Her cranial MR showed cerebellar vermis agenesis and a molar tooth sign. Her laboratory evaluation, and renal and abdominal ultrasound were normal. An electroretinogram showed mixed retinal dystrophy and an AHI1 homozygous missense c.1981T>C mutation was identified (parents are carriers). Throughout infancy, she has shown mild developmental delay and hypotonia, but no respiratory abnormalities. Owing to variable expressivity, a high level of suspicion is required.

Objective Cesarean section (CS) delivery, especially without previous labor, is associated with worse neonatal respiratory outcomes. Some studies comparing neonatal outcomes between term infants exposed and not exposed to antenatal corticosteroids (ACS) before elective CS revealed that ACS appears to decrease the risk of respiratory distress syndrome (RDS), transient tachypnea of the neonate (TTN), admission to the neonatal intensive care unit (NICU), and the length of stay in the NICU. Methods The present retrospective cohort study aimed to compare neonatal outcomes in infants born trough term elective CS exposed and not exposed to ACS. Outcomes included neonatal morbidity at birth, neonatal respiratory morbidity, and general neonatal morbidity. Maternal demographic characteristics and obstetric data were analyzed as possible confounders. Results A total of 334 newborns met the inclusion criteria. One third of the population study (n = 129; 38.6%) received ACS. The present study found that the likelihood for RDS (odds ratio [OR] = 1.250; 95% confidence interval [CI]: 0.454–3.442), transient TTN (OR = 1.,623; 95%CI: 0.556–4.739), and NIUC admission (OR = 2.155; 95%CI: 0.474–9.788) was higher in the ACS exposed group, although with no statistical significance. When adjusting for gestational age and arterial hypertension, the likelihood for RDS (OR = 0,732; 95%CI: 0.240–2.232), TTN (OR = 0.959; 95%CI: 0.297–3.091), and NIUC admission (OR = 0,852; 95%CI: 0.161–4.520) become lower in the ACS exposed group. Conclusion Our findings highlight the known association between CS-related respiratory morbidity and gestational age, supporting recent guidelines that advocate postponing elective CSs until 39 weeks of gestational age.

Introduction: Late preterm infants (LPT) are at high risk for perinatal acute morbidity and mortality. This risk seems to be lower with increasing gestational age (GA). We aim to discuss if an individual approach to the LPT according to GA is justified. Materials and Methods: A secondary analysis of a retrospective study on antenatal corticosteroids in LPT birth was performed. Singleton, nonanomalous, delivered at 34–36 weeks infants born between January 1 2012, and December 31 2017 were included and classified into three groups according to GA at birth: 34+0 to 34+6 weeks; 35+0 to 35+6; 36+0 to 36+6. Primary outcomes included neonatal morbidity at birth and neonatal respiratory morbidity in the first 72 hours. Maternal demographic and obstetric data were analyzed as possible confounders. Results: From a total of 390 LPT, 58.4% were born at 36 weeks, 24.9% at 35 and 16.7% at 34. Respiratory morbidity was 7 times higher in 34w than in 36w neonates. Comparing with 36w, 34w neonates reported 2.6 times more jaundice and 9 times more NICU admission. Neonates born at 34 weeks were more likely to present, with statistical significance: need of oxygen supplementation at birth and in the first 72 hours of life; need for non-invasive respiratory support; RDS of newborn; TTN; NICU admission; prolonged hospital stay for more than seven days; need for nutrition through nasogastric tube; jaundice with need for phototherapy; sepsis evaluation; treatment with antibiotics; hypoglycemia. Respiratory and non-respiratory outcomes decreased with increasing GA. Discussion: These findings suggest that one week makes a difference in neonatal outcomes. Whenever possible efforts should be made to postpone preterm delivery. A discussion about individual approach to LPT according to GA should be raised. GA-specific guidelines could be justified to anticipate and prevent morbidity in perinatal life.

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