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The role of maternal infection in preterm birth: evidence from the Brazilian Multicentre Study on Preterm Birth (EMIP).

母亲感染在早产中的作用: 来自巴西早产多中心研究 (EMIP) 的证据。

  • 影响因子:1.35
  • DOI:10.6061/clinics/2020/e1508
  • 作者列表:"Tedesco RP","Galvão RB","Guida JP","Passini-Júnior R","Lajos GJ","Nomura ML","Rehder PM","Dias TZ","Souza RT","Cecatti JG","Group Brazilian Multicentre Study on Preterm Birth Study.
  • 发表时间:2020-03-23
Abstract

OBJECTIVES:Evidence suggests that infection or inflammation is a major contributor to early spontaneous preterm birth (sPTB). Therefore, this study aimed to investigate the development and causes of maternal infection associated with maternal and neonatal outcomes in women with sPTB. METHODS:This was a secondary analysis of a multicenter cross-sectional study with a nested case-control component, the Brazilian Multicentre Study on Preterm Birth (EMIP), conducted from April 2011 to July 2012 in 20 Brazilian referral obstetric hospitals. Women with preterm birth (PTB) and their neonates were enrolled. In this analysis, 2,682 women undergoing spontaneous preterm labor and premature pre-labor rupture of membranes were included. Two groups were identified based on self-reports or prenatal or hospital records: women with at least one infection factor and women without any maternal infection (vulvovaginitis, urinary tract infection, or dental infection). A bivariate analysis was performed to identify potential individual risk factors for PTB. The odds ratios (ORs) with their respective 95% confidence intervals were calculated. RESULTS:The majority of women with sPTB fulfilled at least one criterion for the identification of maternal infection (65.9%), and more than half reported having urinary tract infection during pregnancy. Approximately 9.6% of women with PTB and maternal infection were classified as having periodontal infection only. Apart from the presence of a partner, which was more common among women with infectious diseases (p=0.026; OR, 1.28 [1.03-1.59]), other variables did not show any significant difference between groups. CONCLUSION:Maternal infection was highly prevalent in all cases of sPTBs, although it was not clearly associated with the type of PTB, gestational age, or any adverse neonatal outcomes.

摘要

目的: 有证据表明感染或炎症是早期自发性早产 (sPTB) 的主要原因。因此,本研究旨在调查sPTB妇女中与母婴结局相关的孕产妇感染的发生和原因。 方法: 这是一项多中心横断面研究的二次分析,该研究采用巢式病例对照成分,即2011年4月至2012年7月在20家巴西转诊产科医院进行的巴西早产多中心研究 (EMIP)。纳入早产 (PTB) 妇女及其新生儿。在这项分析中,2,682名经历自发性早产和早产胎膜早破的妇女被包括在内。根据自我报告或产前或医院记录确定两组: 具有至少一种感染因素的妇女和没有任何母体感染 (外阴阴道炎,尿路感染或牙科感染) 的妇女。进行双变量分析以确定PTB的潜在个体风险因素。计算比值比 (or) 及其各自的95% 置信区间。 结果: 大多数患有sPTB的妇女至少满足了一个鉴定母体感染的标准 (65.9%),超过一半的妇女报告在怀孕期间患有尿路感染。大约9.6% 患有PTB和母体感染的女性被归类为仅患有牙周感染。除了在感染性疾病的女性中更常见的伴侣存在 (p = 0.026; OR,1.28 [1.03-1.59]),其他变量在组间没有显示任何显著差异。 结论: 在所有sPTBs病例中,产妇感染都非常普遍,尽管它与PTB的类型、胎龄或任何不良新生儿结局没有明显的相关性。

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影响因子:1.46
发表时间:2020-01-01
来源期刊:The Journal of urology
DOI:10.1097/JU.0000000000000521
作者列表:["Parizi JLG","Leal da Cruz M","Andrade MC","Garrone G","Ottoni SL","Cavalheiro S","Moron A","Macedo A Jr"]

METHODS:PURPOSE:In utero myelomeningocele closure is a valid alternative to postnatal repair with unclear benefits to bladder function. We compared bladder status in patients who underwent fetal myelomeningocele surgery versus postnatal repair. MATERIALS AND METHODS:We retrospectively reviewed our database, with group 1 consisting of in utero surgery and group 2 consisting of postnatal repair. Group 3 was a subgroup of group 2, including patients initially presenting at age less than 12 months. We recorded medical history, radiological investigation with renal ultrasonography, voiding cystourethrography, urodynamic evaluation and clinical outcome of the bladder pattern after treatment. RESULTS:We identified 88 patients in group 1, 86 in group 2 and 38 in group 3. The incidence of urinary tract infection was higher in the postnatal period (45% vs 20%). Hydronephrosis occurred in 20.7%, 22.6% and 28.9% of patients in groups 1, 2 and 3, respectively. Vesicoureteral reflux was diagnosed in 15% in all groups. Urodynamic data showed a higher prevalence of detrusor overactivity in group 1 and no difference in other urodynamic parameters. The high risk bladder pattern at initial evaluation occurred in 56%, 50% and 46% of patients in groups 1, 2 and 3, respectively. There was a trend to decrease the percentages of the high risk bladder pattern and to increase the normal pattern after treatment in all groups. CONCLUSIONS:In utero repair did not improve urological parameters compared to repair in the postnatal period.

翻译标题与摘要 下载文献
影响因子:2.09
发表时间:2020-04-01
DOI:10.1016/j.jiph.2019.08.014
作者列表:["Kayode A","Okunrounmu P","Olagbende A","Adedokun O","Hassan AW","Atilola G"]

METHODS::The development and evolution of antimicrobial resistance (AMR) in pathogens has been reported to be one of the major issues confronting the global health community. The aim of this study was to examine the period prevalence of antibiotic resistance, as well as the trends and patterns in sensitivity profile of enteric bacteria isolated from urine samples of patients with UTIs in a teaching Hospital in south west Nigeria. Urine samples were collected from 77 patients with UTIs from February 2017 to October 2018. Standard laboratory methods were used for urine sample culture and bacterial identification. The Kirby-Bauer disk diffusion method was used to evaluate antimicrobial sensitivity. Predominant enteric bacteria isolates were Escherichia coli (24, 39.3%), Salmonella species (12, 19.7%), Klebsiella species (4, 6.6%), Providencia species (6, 9.8%), Proteus species (8, 13.1%), Serratia species (2, 3.3%), Yersinia species (1, 1.6%) and Morganella species (4, 6.6%). A large proportion (90.2%) of isolates obtained were multi-drug resistant. High resistance in amoxycillin-clavulanate (98%), cefuroxime (92%), erythromycin (90%) and ceftazidime (84%) were recorded. These results emphasize the importance of continuous screening and surveillance programmes for detection of AMR in enteric bacteria of public health importance.

翻译标题与摘要 下载文献
影响因子:1.09
发表时间:2020-01-01
DOI:10.1097/CIN.0000000000000562
作者列表:["Park JI","Bliss DZ","Chi CL","Delaney CW","Westra BL"]

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尿路感染方向

尿路上皮对细菌侵入导致的炎症反应,通常伴随有菌尿和脓尿。

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