Background:- Cytomegalovirus, a Herpes virus is the most common virus causing congenital viral infections. Sensorineueal hearing loss is the most common non hereditary manifestation. Majority of the babies are asymptomatic or have non specific symptoms at birth. An early diagnosis can help in starting antiviral treatment based on the clinical disease to prevent end organ damage and to intervene early in babies with hearing impairment which can reduce long term sequelae. Objectives :- The aim of the study is to diagnose and quantitate neonatal CMV infection by qRTPCR (Quantitative Real Time Polymerase Chain Reaction) ,to evaluate the proportion and clinical profile of congenital CMV infections in a tertiary care hospital. Materials and Methods:- This cross sectional diagnostic evaluation was done in the Dept. of Microbiology and Neonatal unit of Dept of Paediatrics, Govt Medical college .Kozhikode from August 2017 to December 2018. Details of demographic data, clinical profile, and CMV viral load in urine in various clinical infections were obtained and analyzed. Urine samples from 225 babies were received and processed in the Microbiology Department. DNA isolation and amplification was performed using commercial DNA extraction kit and CMV PCR kit for detection and quantification of CMV. Results:- Of 225 babies with clinical features suggestive of CMV infection, CMV-DNA was detected and quantitated in urine of 27 babies (12%). The most common clinical presentation was hearing impairment, seen in 22 babies. Conclusion:- RT-qPCR helps in diagnosing and quantitating CMV in congenital neonatal infection which helps in deciding on therapy and assessing response to treatment,and can predict risk for long term sequelae. Diagnosis of congenital CMV in the newborn period is important for identifying those with neurologic abnormalities where appropriate treatment and management is essential. Keywords: Congenital CMV, qRTPCR, SNHL, Viral load, Urine.
Introduction: Group B Streptococcus (GBS) is the leading cause of neonatal sepsis all over the world. Maternal colonisation of GBS in vaginal and anorectal area poses risk for subsequent invasive disease. The prevalence of maternal colonisation varies with geographical, biological and socio-economical factors. Current recommendations consider maternal screening and antibiotic therapy to prevent GBS neonatal disease with a potential of alteration of infant gut flora. Aim: To find out the prevalence, outcome and antimicrobial susceptibility pattern of the GBS colonisation in antenatal women. Materials and Methods: A hospital-based descriptive crosssectional study was conducted in Government Medical College, Kozhikode, Kerala, India, during December 2017 to May 2019 including 300 antenatal women of 35-37 weeks gestational age. Vaginal and rectal swabs were taken and were subjected to microbiological examination and culture. Data analysis was done by Statistical Package for the Social Sciences (SPSS) version 16.0. The Chi-square test and Fisher’s exact test were used wherever applicable and p-value <0.05 is considered significant. Results: Among the 300 antenatal women, 8 (2.7%) were colonised with GBS. Higher rate of colonisation was observed in women of 21-25 years, higher parity, rural dwelling and in women with poor glycaemic control. All the colonised women received antibiotic prophylaxis with intravenous ampicillin. None of the colonised women or the neonates born to them developed any invasive GBS infection. Antibiotic susceptibility testing showed that all the isolates were sensitive to penicillin, ampicillin and vancomycin but only 62.5% of the isolates were susceptible to clindamycin and 37.5% of the isolates were susceptible to erythromycin. Conclusion: The prevalence of GBS colonisation is low in Asian countries, compared to the data from western countries. Evidence based usage of narrow spectrum antibiotics should be considered. Further studies regarding prevalence, antibiotic susceptibility pattern, cost benefit analysis of the antibiotic usage and its effect on neonatal gut flora etc, including a wider population, is a need of the hour in the setting of emergence of resistance.
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