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class="vector-toc-list"> </ul> </li> <li id="toc-Clostridium_tetani" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Clostridium_tetani"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1.5</span> <span><i>Clostridium tetani</i></span> </div> </a> <ul id="toc-Clostridium_tetani-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_bacterial_pathogens" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Other_bacterial_pathogens"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1.6</span> <span>Other bacterial pathogens</span> </div> </a> <ul id="toc-Other_bacterial_pathogens-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Viruses" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Viruses"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Viruses</span> </div> </a> <ul id="toc-Viruses-sublist" class="vector-toc-list"> <li id="toc-Human_immunodeficiency_virus_(HIV)" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Human_immunodeficiency_virus_(HIV)"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2.1</span> <span>Human immunodeficiency virus (HIV)</span> </div> </a> <ul id="toc-Human_immunodeficiency_virus_(HIV)-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Cytomegalovirus_(CMV)" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Cytomegalovirus_(CMV)"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2.2</span> <span>Cytomegalovirus (CMV)</span> </div> </a> <ul id="toc-Cytomegalovirus_(CMV)-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Herpes_simplex_virus_(HSV)" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Herpes_simplex_virus_(HSV)"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2.3</span> <span>Herpes simplex virus (HSV)</span> </div> </a> <ul id="toc-Herpes_simplex_virus_(HSV)-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Rubella" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Rubella"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2.4</span> <span>Rubella</span> </div> </a> <ul id="toc-Rubella-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Zika" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Zika"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2.5</span> <span>Zika</span> </div> </a> <ul id="toc-Zika-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Hepatitis" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Hepatitis"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2.6</span> <span>Hepatitis</span> </div> </a> <ul id="toc-Hepatitis-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Other_viral_pathogens" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_viral_pathogens"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Other viral pathogens</span> </div> </a> <ul id="toc-Other_viral_pathogens-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Fungi" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Fungi"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.4</span> <span>Fungi</span> </div> </a> <ul id="toc-Fungi-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Protozoans" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Protozoans"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.5</span> <span>Protozoans</span> </div> </a> <ul id="toc-Protozoans-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Risk_factors" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Risk_factors"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Risk factors</span> </div> </a> <ul id="toc-Risk_factors-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mechanism" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Mechanism"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Mechanism</span> </div> </a> <button aria-controls="toc-Mechanism-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Mechanism subsection</span> </button> <ul id="toc-Mechanism-sublist" class="vector-toc-list"> <li id="toc-Pathogenesis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Pathogenesis"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Pathogenesis</span> </div> </a> <ul id="toc-Pathogenesis-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Diagnosis</span> </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Diagnosis subsection</span> </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Viral_infection" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Viral_infection"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.1</span> <span>Viral infection</span> </div> </a> <ul id="toc-Viral_infection-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Protozoan_infection" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Protozoan_infection"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.2</span> <span>Protozoan infection</span> </div> </a> <ul id="toc-Protozoan_infection-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Neonatal_sepsis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Neonatal_sepsis"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.3</span> <span>Neonatal sepsis</span> </div> </a> <ul id="toc-Neonatal_sepsis-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Prevention</span> </div> </a> <ul id="toc-Prevention-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Treatment"> <div 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id="toc-Early-onset_infections-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Late_onset_infections" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Late_onset_infections"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.2</span> <span>Late onset infections</span> </div> </a> <ul id="toc-Late_onset_infections-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>Research</span> </div> </a> <ul id="toc-Research-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">12</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">13</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div 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class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Infecci%C3%B3n_neonatal" title="Infección neonatal – Spanish" lang="es" hreflang="es" data-title="Infección neonatal" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%86%D5%B8%D6%80%D5%A1%D5%AE%D5%B6%D5%A1%D5%B5%D5%AB%D5%B6_%D5%AB%D5%B6%D6%86%D5%A5%D5%AF%D6%81%D5%AB%D5%A1%D5%B6%D5%A5%D6%80" title="Նորածնային ինֆեկցիաներ – Armenian" lang="hy" hreflang="hy" data-title="Նորածնային ինֆեկցիաներ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%96%D7%99%D7%94%D7%95%D7%9D_%D7%95%D7%9C%D7%93%D7%99" title="זיהום ולדי – Hebrew" lang="he" hreflang="he" data-title="זיהום ולדי" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Zaka%C5%BCenia_okresu_noworodkowego" title="Zakażenia okresu noworodkowego – Polish" lang="pl" hreflang="pl" data-title="Zakażenia okresu noworodkowego" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Infec%C3%A7%C3%A3o_perinatal" title="Infecção perinatal – Portuguese" lang="pt" hreflang="pt" data-title="Infecção perinatal" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-si mw-list-item"><a href="https://si.wikipedia.org/wiki/%E0%B7%85%E0%B6%AF%E0%B6%BB%E0%B7%94_%E0%B6%86%E0%B7%83%E0%B7%8F%E0%B6%AF%E0%B6%B1" title="ළදරු ආසාදන – Sinhala" lang="si" hreflang="si" data-title="ළදරු ආසාදන" data-language-autonym="සිංහල" data-language-local-name="Sinhala" class="interlanguage-link-target"><span>සිංහල</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Nhi%E1%BB%85m_tr%C3%B9ng_s%C6%A1_sinh" title="Nhiễm trùng sơ sinh – Vietnamese" lang="vi" hreflang="vi" data-title="Nhiễm trùng sơ sinh" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E6%96%B0%E7%94%9F%E5%84%BF%E6%84%9F%E6%9F%93" title="新生儿感染 – Chinese" lang="zh" 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<div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Human disease</div> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Neonatal infection</th></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Premature_infant_with_ventilator.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Premature_infant_with_ventilator.jpg/220px-Premature_infant_with_ventilator.jpg" decoding="async" width="220" height="293" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Premature_infant_with_ventilator.jpg/330px-Premature_infant_with_ventilator.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Premature_infant_with_ventilator.jpg/440px-Premature_infant_with_ventilator.jpg 2x" data-file-width="768" data-file-height="1024" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">26-week gestation, premature infant, weighing <990gm with ventilator</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Infectious_disease_(medical_specialty)" class="mw-redirect" title="Infectious disease (medical specialty)">Infectious disease</a>, <a href="/wiki/Pediatrics" title="Pediatrics">Pediatrics</a></td></tr></tbody></table> <p><b>Neonatal infections</b> are infections of the <a href="/wiki/Infant" title="Infant">neonate</a> (newborn) acquired during <a href="/wiki/Prenatal_development" title="Prenatal development">prenatal development</a> or within the first four weeks of life.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Neonatal infections may be contracted by <a href="/wiki/Vertically_transmitted_infection" title="Vertically transmitted infection">mother to child</a> <a href="/wiki/Transmission_(medicine)" class="mw-redirect" title="Transmission (medicine)">transmission</a>, in the <a href="/wiki/Vagina" title="Vagina">birth canal</a> during <a href="/wiki/Childbirth" title="Childbirth">childbirth</a>, or after birth.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Neonatal infections may present soon after delivery, or take several weeks to show symptoms. Some neonatal infections such as <a href="/wiki/HIV/AIDS" title="HIV/AIDS">HIV</a>, <a href="/wiki/Hepatitis_B" title="Hepatitis B">hepatitis B</a>, and <a href="/wiki/Malaria" title="Malaria">malaria</a> do not become apparent until much later. Signs and symptoms of infection may include <a href="/wiki/Respiratory_distress" class="mw-redirect" title="Respiratory distress">respiratory distress</a>, temperature instability, <a href="/wiki/Irritability" title="Irritability">irritability</a>, <a href="/wiki/Poor_feeding" class="mw-redirect" title="Poor feeding">poor feeding</a>, <a href="/wiki/Failure_to_thrive" title="Failure to thrive">failure to thrive</a>, persistent crying and skin rashes. </p><p>Risk factors include previous maternal infection, <a href="/wiki/Preterm_delivery" class="mw-redirect" title="Preterm delivery">preterm delivery</a> (< 37 weeks gestation) and <a href="/wiki/Premature_rupture_of_membranes" class="mw-redirect" title="Premature rupture of membranes">premature rupture of membranes</a> (breakage of the <a href="/wiki/Amniotic_sac" title="Amniotic sac">amniotic sac</a>) which substantially increases the risk of <a href="/wiki/Neonatal_sepsis" title="Neonatal sepsis">neonatal sepsis</a> by allowing passage for bacteria to enter the womb prior to the birth of the infant. Preterm or <a href="/wiki/Low_birth_weight" title="Low birth weight">low birth weight</a> neonates are more vulnerable to neonatal infection. While preterm neonates are at a particularly high risk, all neonates can develop infection. Maternal screening for intrapartum infections reduce the risk of neonatal infection. Pregnant women may receive intrapartum antibiotic prophylaxis for prevention of neonatal infection.<sup id="cite_ref-NBK531478_3-0" class="reference"><a href="#cite_note-NBK531478-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Infant_respiratory_distress_syndrome" title="Infant respiratory distress syndrome">Infant respiratory distress syndrome</a> is a common complication of neonatal infection, a condition that causes difficulty breathing in preterm neonates. Respiratory distress syndrome can arise following neonatal infection, and this syndrome may have long-term negative consequences. In some instances, neonatal respiratory tract diseases may increase the susceptibility to future respiratory infections and inflammatory responses related to lung disease.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Antibiotics" class="mw-redirect" title="Antibiotics">Antibiotics</a> can be effective for neonatal infections, especially when the <a href="/wiki/Pathogen" title="Pathogen">pathogen</a> is quickly identified. Instead of relying solely on culturing techniques, pathogen identification has improved substantially with advancing technology; however, <a href="/wiki/Infant_mortality" title="Infant mortality">neonate mortality</a> reduction has not kept pace. In industrialized countries, <a href="/wiki/Medical_treatment" class="mw-redirect" title="Medical treatment">treatment</a> for neonatal infections takes place in the <a href="/wiki/Neonatal_intensive_care_unit" title="Neonatal intensive care unit">neonatal intensive care unit</a> (NICU). Neonatal infection can be distressing to the family and it initiates concentrated effort to treat it by <a href="/wiki/Clinicians" class="mw-redirect" title="Clinicians">clinicians</a>. Research to improve treatment of infections and prophylactic treatment of the mother to avoid infections of the infant is ongoing.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Signs and symptoms of infection include respiratory distress, temperature instability, irritability, failure to thrive, and skin rashes.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2023)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Etiologies">Etiologies</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=2" title="Edit section: Etiologies"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Early-onset sepsis (EOS), defined as onset of symptoms within 72 hours of life, is generally caused by transmission of <a href="/wiki/Pathogen" title="Pathogen">pathogens</a> from the <a href="/wiki/Genitourinary_system" title="Genitourinary system">female genitourinary system</a> to the fetus. Pathogens can infect the fetus via <a href="/wiki/Vertical_transmission" title="Vertical transmission">vertical transmission</a> (direct transmission through the placenta in utero) or infection during delivery as fetus passes through <a href="/wiki/Vagina" title="Vagina">vaginal canal.</a> </p><p>Late-onset sepsis (LOS), defined as onset of symptoms after 72 hours of life, is generally caused by transmission of pathogens from the environment after delivery. Infants requiring intravascular catheters and other invasive procedures are at increased risk for developing LOS.<sup id="cite_ref-NBK531478_3-1" class="reference"><a href="#cite_note-NBK531478-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>There are many etiologies of neonatal infection, including bacterial, viral and fungal pathogens. The source of infectious <a href="/wiki/Bacteria" title="Bacteria">bacteria</a> and other pathogens is often the <a href="/wiki/Mother" title="Mother">maternal</a> <a href="/wiki/Gastrointestinal_tract" title="Gastrointestinal tract">gastrointestinal</a> and <a href="/wiki/Genitourinary_system" title="Genitourinary system">genitourinary tract</a>. Many of the maternal infections with these organisms are <a href="/wiki/Asymptomatic" title="Asymptomatic">asymptomatic</a> in the mother. Other maternal infections that may be transmitted to the infant in <a href="/wiki/Vertical_transmission" title="Vertical transmission">utero</a> or during birth are bacterial and viral <a href="/wiki/Sexually_transmitted_infection" title="Sexually transmitted infection">sexually transmitted infections</a>. The infant's ability to resist infection is limited by its immature <a href="/wiki/Immune_system" title="Immune system">immune system</a>. In addition, the immune system of the neonate may respond in ways that can create problems that complicate treatment, such as the release of <a href="/wiki/Cytokine" title="Cytokine">inflammatory chemicals</a>. Congenital defects of the immune system also affect the infants ability to fight off the infection.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Bacteria">Bacteria</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=3" title="Edit section: Bacteria"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Bacteria found in the maternal gastrointestinal or gastrourinary tracts can commonly lead to neonatal infection. Bacterial infections may present as fetal distress at birth (including signs of tachycardia, temperature instability or difficulty breathing), neonatal sepsis, or neonatal meningitis. Infections that develop during NICU admissions are more commonly coagulase-negative staphylococci, especially in infants with indwelling catheters. Infections that develop one month after the birth of the infant are more likely due to <a href="/wiki/Gram-positive_bacteria" title="Gram-positive bacteria">gram-positive bacteria</a> and <a href="/wiki/Staphylococcus" title="Staphylococcus">coagulase positive staphylococci</a>.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> ... </p> <div class="mw-heading mw-heading4"><h4 id="Group_B_streptococcus_(GBS)"><span id="Group_B_streptococcus_.28GBS.29"></span>Group B streptococcus (GBS)</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=4" title="Edit section: Group B streptococcus (GBS)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Streptococcus_agalactiae" title="Streptococcus agalactiae">Group B streptococcus</a> (GBS), also named <i>Streptococcus agalactiae</i>, is a bacteria typically identified as the cause of the majority of early-onset infections in the neonate. GBS is an encapsulated gram-positive cocci that colonizes the gastrointestinal and genital tracts of pregnant women. Maternal infections are usually asymptomatic. This pathogen is <a href="/wiki/Vertically_transmitted_infection" title="Vertically transmitted infection">vertically transmitted</a> (transmitted directly from the mother's vagina into the infant's amniotic fluid after onset of labor). Due to the high prevalence of GBS, routine screening for the bacteria occurs during pregnancy. If the bacteria is found in the maternal GI / GU tract, mothers will receive IV antibiotic (usually penicillin or ampicillin).<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Escherichia_coli_(E._coli)"><span id="Escherichia_coli_.28E._coli.29"></span>Escherichia coli (E. coli)</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=5" title="Edit section: Escherichia coli (E. coli)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><i><a href="/wiki/Escherichia_coli" title="Escherichia coli">Escherichia coli</a></i> is an encapsulated gram-negative bacilli that may cause neonatal infections due to its high prevalence in the GI and GU tracts of pregnant patients. With the advances in preventing group B streptococcus infections, β-lactam-resistant <i><a href="/wiki/Escherichia_coli" title="Escherichia coli">Escherichia coli</a></i> infections have increased in causing neonatal deaths in very low birthweight and premature infants. Common complications of neonatal E.coli infection include neonatal sepsis and neonatal meningitis.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Neisseria_gonorrhoeae"><i>Neisseria gonorrhoeae</i></h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=6" title="Edit section: Neisseria gonorrhoeae"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><i><a href="/wiki/Neisseria_gonorrhoeae" title="Neisseria gonorrhoeae">Neisseria gonorrhoeae</a></i> is a common <a href="/wiki/Sexually_transmitted_infection" title="Sexually transmitted infection">sexually transmitted infection</a> which may be present in pregnant women at time of delivery. This pathogen is usually acquired during delivery, occurring in 30-40% of cases with known maternal infection. Additionally, untreated maternal gonorrhea may increase the risk of <a href="/wiki/Preterm_birth" title="Preterm birth">preterm delivery.</a> The most common manifestation of gonococcal infection in a newborn is <a href="/wiki/Neonatal_conjunctivitis" title="Neonatal conjunctivitis">neonatal conjunctivitis</a>, an infection of the eyes that presents with green-yellow <a href="/wiki/Exudate" title="Exudate">exudate</a> and eyelid swelling. Without treatment, this infection can lead to permanent <a href="/wiki/Visual_impairment" title="Visual impairment">visual impairment</a>. Treatment of <i><a href="/wiki/Neisseria_gonorrhoeae" title="Neisseria gonorrhoeae">Neisseria gonorrhoeae</a></i> conjunctivitis consists of a single dose of <a href="/wiki/Ceftriaxone" title="Ceftriaxone">ceftriaxone</a> (antibiotic). Typically, all neonates (regardless of symptoms or risk factors) receive <a href="/wiki/Erythromycin" title="Erythromycin">erythromycin</a> ointment applied to both eyes after delivery<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Listeria_monocytogenes"><i>Listeria monocytogenes</i></h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=7" title="Edit section: Listeria monocytogenes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><i><a href="/wiki/Listeria_monocytogenes" title="Listeria monocytogenes">Listeria monocytogenes</a></i> is a gram-positive bacilli that can cause infection acquired from <a href="/wiki/Foodborne_illness" title="Foodborne illness">tainted food</a> and present in the mother. The presence of this pathogen can sometimes be determined by the symptoms that appear as a <a href="/wiki/Gastrointestinal_disease" title="Gastrointestinal disease">gastrointestinal illness</a> in the mother. The mother acquires infection from ingesting food that contains <a href="/wiki/Animal_product" title="Animal product">animal products</a> such as <a href="/wiki/Hot_dog" title="Hot dog">hot dogs</a>, <a href="/wiki/Pasteurization" title="Pasteurization">unpasteurized</a> <a href="/wiki/Milk" title="Milk">milk</a>, <a href="/wiki/Smoked_meat" title="Smoked meat">delicatessen meats</a>, and <a href="/wiki/Cheese" title="Cheese">cheese</a>.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Clostridium_tetani"><i>Clostridium tetani</i></h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=8" title="Edit section: Clostridium tetani"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><i><a href="/wiki/Clostridium_tetani" title="Clostridium tetani">Clostridium tetani</a></i> can cause a generalised form of <a href="/wiki/Neonatal_tetanus" title="Neonatal tetanus">tetanus</a> in the neonate. This usually occurs when the mother has not been vaccinated against tetanus and the baby has not acquired passive immunity. The umbilical cord region is the most susceptible.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Other_bacterial_pathogens">Other bacterial pathogens</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=9" title="Edit section: Other bacterial pathogens"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Less common bacterial pathogens include <i><a href="/wiki/Streptococcus_pyogenes" title="Streptococcus pyogenes">Streptococcus pyogenes</a></i>, <i><a href="/wiki/Viridans_streptococci" title="Viridans streptococci">Viridans streptococci</a></i>, <i><a href="/wiki/Streptococcus_pneumoniae" title="Streptococcus pneumoniae">Streptococcus pneumoniae</a></i>, <i><a href="/wiki/Haemophilus_influenzae" title="Haemophilus influenzae">Haemophilus influenzae</a></i>, and <i><a href="/wiki/Pseudomonas_aeruginosa" title="Pseudomonas aeruginosa">Pseudomonas aeruginosa</a></i>.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2023)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Viruses">Viruses</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=10" title="Edit section: Viruses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading4"><h4 id="Human_immunodeficiency_virus_(HIV)"><span id="Human_immunodeficiency_virus_.28HIV.29"></span>Human immunodeficiency virus (HIV)</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=11" title="Edit section: Human immunodeficiency virus (HIV)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/HIV" title="HIV">Human immunodeficiency virus</a> (HIV) infection can occur during delivery of the neonate, in utero through mother-to-child transmission or postnatally by way of breastfeeding. Most transmission occurs during delivery. Transmission depends on multiple risk factors, usually centered around the viral load of HIV in the mother. Strategies for reducing transmission of HIV include: </p> <ul><li><a href="/wiki/Anti-Retroviral_Therapy" class="mw-redirect" title="Anti-Retroviral Therapy">Anti-retroviral therapy</a> during pregnancy, reducing amount of HIV virus in the maternal bloodstream</li> <li>Delivery by <a href="/wiki/Caesarean_section" title="Caesarean section">caesarean section</a> in mothers with plasma viral load > 1000 copies / mL</li> <li>Using prophylactic anti-retroviral therapy in the newborn infant, especially in mothers with high viral loads</li> <li>Avoiding breast-feeding<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup></li></ul> <p>Symptoms of HIV in a child will vary depending on the age of presentation. Common symptoms include <a href="/wiki/Failure_to_thrive" title="Failure to thrive">failure to thrive</a>, recurrent infections such as <a href="/wiki/Pneumonia" title="Pneumonia">pneumonia</a>, intermittent diarrhea, swollen lymph nodes and <a href="/wiki/Oral_candidiasis" title="Oral candidiasis">oral thrush</a>. In infants, diagnostic testing for HIV relies of detection of the virus in the bloodstream. For infants born to HIV-infected mothers, diagnostic testing will be performed within days of delivery, at 1–2 months and at 4–6 months of age.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Cytomegalovirus_(CMV)"><span id="Cytomegalovirus_.28CMV.29"></span>Cytomegalovirus (CMV)</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=12" title="Edit section: Cytomegalovirus (CMV)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Cytomegalovirus" title="Cytomegalovirus">Cytomegalovirus (CMV)</a> is the most common congenital viral infection, usually transmitted through the placenta during pregnancy. Most neonates with congenital CMV infection will not have any symptoms, but a minority of infected newborns will have symptomatic infection. Common symptoms include rash, <a href="/wiki/Microcephaly" title="Microcephaly">microcephaly</a> (small head), <a href="/wiki/Low_birth_weight" title="Low birth weight">low birth weight</a>, <a href="/wiki/Jaundice" title="Jaundice">jaundice</a>, <a href="/wiki/Thrombocytopenia" title="Thrombocytopenia">thrombocytopenia</a>, seizures and <a href="/wiki/Retinitis" title="Retinitis">retinitis</a>. Long-term complications of congenital CMV infections may include <a href="/wiki/Sensorineural_hearing_loss" title="Sensorineural hearing loss">sensorineural hearing loss</a>, <a href="/wiki/Global_developmental_delay" title="Global developmental delay">developmental delay</a>, and seizures. Due to high prevalence of disease, CMV is not routinely screened in pregnant patients.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Herpes_simplex_virus_(HSV)"><span id="Herpes_simplex_virus_.28HSV.29"></span>Herpes simplex virus (HSV)</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=13" title="Edit section: Herpes simplex virus (HSV)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Neonatal_herpes_simplex" class="mw-redirect" title="Neonatal herpes simplex">Neonatal herpes simplex</a></div> <p><a href="/wiki/Herpes_simplex_virus" title="Herpes simplex virus">Herpes simplex virus</a> (HSV), which commonly causes cold sores and painful genital blisters can cause congenital infection via direct contact with genital tract lesions during delivery. Neonatal HSV may be classified into three categories based on symptom presentation: </p> <ul><li>Localized skin, eye and mouth disease: 35–45% of neonatal HSV infections. Presentation includes clustering <a href="/wiki/Vesiculation" class="mw-redirect" title="Vesiculation">vesicular lesions</a> (blister-like) with <a href="/wiki/Erythematous" class="mw-redirect" title="Erythematous">erythematous</a> (skin redness) base in localized area of skin which can spread to the eye or oropharynx. There is risk of progression to CNS or disseminated disease, so infants should be thoroughly evaluated for progression of symptoms.</li> <li>CNS disease: 30% of neonatal HSV infections. HSV spreads into the brain, leading to <a href="/wiki/Seizure" title="Seizure">seizures</a>, <a href="/wiki/Lethargy" title="Lethargy">lethargy</a>, irritability, poor feeding, temperature instability within the first six weeks of life. Diagnosis of CNS disease can be made with <a href="/wiki/Cerebrospinal_fluid_analysis" class="mw-redirect" title="Cerebrospinal fluid analysis">cerebrospinal fluid analysis</a> or <a href="/wiki/EEG" class="mw-redirect" title="EEG">electroencephalogram (EEG)</a> showing lateralized periodic discharges. It can be difficult to distinguish between HSV CNS disease and other causes of <a href="/wiki/Neonatal_meningitis" title="Neonatal meningitis">neonatal meningitis</a>; therefore, it is recommended to start empiric <a href="/wiki/Aciclovir" title="Aciclovir">acyclovir</a> in all cases of neonatal meningitis.</li> <li>Disseminated disease: 25–30% of neonatal HSV infections. Disease is defined by multi-organ involvement, including liver, lungs CNS, heart, kidney, GI tract, and skin. Neonates with disseminated HSV infection present with nonspecific symptoms of <a href="/wiki/Neonatal_sepsis" title="Neonatal sepsis">neonatal sepsis</a>. All infants with signs of neonatal sepsis should undergo testing for HSV and empiric antiviral therapy.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading4"><h4 id="Rubella">Rubella</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=14" title="Edit section: Rubella"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Maternal infection with <a href="/wiki/Rubella_virus" title="Rubella virus">rubella virus</a> during pregnancy can lead to <a href="/wiki/Congenital_rubella_syndrome" title="Congenital rubella syndrome">congenital rubella syndrome</a>. The risk of congenital infection is highest during the first trimester (< 12 weeks). Risk of congenital rubella is increased among immigrant women from countries without adequate vaccination programs. Common symptoms include <a href="/wiki/Cataract" title="Cataract">cataracts</a>, <a href="/wiki/Hearing_Impairment" class="mw-redirect" title="Hearing Impairment">hearing impairment</a>, <a href="/wiki/Developmental_disability" title="Developmental disability">developmental delay</a> and <a href="/wiki/Congenital_heart_defect" title="Congenital heart defect">congenital heart disease.</a><sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Zika">Zika</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=15" title="Edit section: Zika"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Zika virus is an arthropod-borne virus transmitted by <a href="/wiki/Mosquito" title="Mosquito">mosquitos</a>, and infection during pregnancy can lead to severe congenital abnormalities in a newborn. Congenital infection can lead to <a href="/wiki/Intrauterine_growth_restriction" title="Intrauterine growth restriction">fetal growth restriction</a> and CNS abnormalities, including <a href="/wiki/Microcephaly" title="Microcephaly">microcephaly</a>, <a href="/wiki/Ventriculomegaly" title="Ventriculomegaly">ventriculomegaly</a> and intracranial calcifications.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Hepatitis">Hepatitis</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=16" title="Edit section: Hepatitis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There are five liver specific viruses (hepatitis A, B, C, D, E) that could potentially harm the mother and child. Acute hepatitis A virus or acute hepatitis E virus infection present the greatest risk to maternal and fetal health and increased risk of adverse pregnancy outcomes. Hepatitis B, C and D virus present a risk of mother to child transmission but are dependent on the severity of the underlying disease in the mother. However, hepatitis B virus is the major cause of neonatal infection.<sup id="cite_ref-:1_20-0" class="reference"><a href="#cite_note-:1-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p> <ul><li><a href="/wiki/Hepatitis_A" title="Hepatitis A">Hepatitis A</a> is a non-enveloped, single-stranded RNA virus that is spread through the fecal-oral route with the main modes of transmission being close personal contact or ingestion of contaminated food or water. During pregnancy, hepatitis A can cause placental abruption, premature rupture of membranes, and increased rates of preterm labor.<sup id="cite_ref-:1_20-1" class="reference"><a href="#cite_note-:1-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Hepatitis_B" title="Hepatitis B">Hepatitis B</a> is an enveloped, double stranded DNA virus that is spread by exposure to blood, with the main modes of transmission are blood, sexual transmission, or perinatal. During pregnancy, acute hepatitis B infection can result in increased risk of preterm delivery, low birth weight and increased risk of gestational diabetes mellitus. Chronic hepatitis B infection is the largest concern globally. Chronic hepatitis B infection can lead to acute liver failure and increased alanine aminotransferase flares. There is also an increased risk of mother to child transmission and occurs during the delivery of the neonate from an infected mother. Some infected neonates will develop acute hepatitis B and symptomatically will develop abdominal distension, jaundice, clay- colored stools and failure to thrive. However, most infected neonates will be asymptomatic but will chronically have persistent hepatitis B surface antigens in the blood and elevated transaminase levels.<sup id="cite_ref-:1_20-2" class="reference"><a href="#cite_note-:1-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Hepatitis_C" title="Hepatitis C">Hepatitis C</a> is an enveloped, single stranded RNA virus that is spread by exposure to blood, with the main modes of transmission are blood, sexual transmission, or perinatal. Chronic infection with hepatitis C virus may influence pregnancy outcomes, such as increased rates of small for gestational age, intrauterine death, low birthweight, and preterm delivery, but no clear association between these adverse outcomes and hepatitis C infection have been observed. There is also an increased risk of mother to child transmission and is largely attributable to events during the birth process.<sup id="cite_ref-:1_20-3" class="reference"><a href="#cite_note-:1-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Hepatitis_D" title="Hepatitis D">Hepatitis D</a> is a single stranded RNA virus that is spread by exposure to blood, with the main modes of transmission are blood, sexual transmission, or perinatal. There is limited research on the effects of hepatitis D infection on fetal or infant outcomes, but the effects are thought to be similar to those with hepatitis B infection.<sup id="cite_ref-:1_20-4" class="reference"><a href="#cite_note-:1-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Hepatitis_E" title="Hepatitis E">Hepatitis E</a> is a non-enveloped, single stranded RNA virus that is spread through the fecal-oral route with the main modes of transmission being close personal contact or ingestion of contaminated food or water. During pregnancy, acute hepatitis E infections result in an increase in adverse pregnancy outcomes such as increased maternal and fetal morbidity and mortality, acute hepatic failure, and associated complications with preterm birth.<sup id="cite_ref-:1_20-5" class="reference"><a href="#cite_note-:1-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading3"><h3 id="Other_viral_pathogens">Other viral pathogens</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=17" title="Edit section: Other viral pathogens"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Other viral infections, such as <a href="/wiki/Human_respiratory_syncytial_virus" class="mw-redirect" title="Human respiratory syncytial virus">respiratory syncytial virus</a> (RSV), <a href="/wiki/Human_metapneumovirus" title="Human metapneumovirus">metapneumovirus</a> (hMPV), <a href="/wiki/Rhinovirus" title="Rhinovirus">rhinovirus</a>, <a href="/wiki/Human_parainfluenza_viruses" title="Human parainfluenza viruses">parainfluenza</a> (PIV), and <a href="/wiki/Coronavirus" title="Coronavirus">human coronavirus</a> in the neonatal period are associated with recurrent <a href="/wiki/Wheeze" title="Wheeze">wheezing</a> in later childhood.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2023)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Fungi">Fungi</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=18" title="Edit section: Fungi"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In very low birth weight infants (VLBWI), systemic fungus infection is a <a href="/wiki/Hospital-acquired_infection" title="Hospital-acquired infection">hospital-acquired infection</a> with serious consequences. The pathogens are usually <i><a href="/wiki/Candida_albicans" title="Candida albicans">Candida albicans</a></i> and <i><a href="/wiki/Candida_parapsilosis" title="Candida parapsilosis">Candida parapsilosis</a></i>. A small percentage of fungal infections are caused by <i><a href="/wiki/Aspergillus" title="Aspergillus">Aspergillus</a></i>, <i><a href="/wiki/Zygomycota" title="Zygomycota">Zygomycetes</a></i>, <i><a href="/wiki/Malassezia" title="Malassezia">Malassezia</a></i>, and <i><a href="/wiki/Trichosporon" title="Trichosporon">Trichosporon</a></i>.<sup id="cite_ref-Martin2015_22-0" class="reference"><a href="#cite_note-Martin2015-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Cloherty2012_23-0" class="reference"><a href="#cite_note-Cloherty2012-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> Infection is usually late-onset. Up to 9% of VLBWI with birth weights of <1,000 g develop these fungus infections leading to sepsis or meningitis. As many as one-third of these infants can die. Candidiasis is associated with retinopathy, prematurity and negative neurodevelopmental consequences. Candida can colonize the gastrointestinal tract of low birthweight infants (LBI). This gastrointestinal colonization is often a precursor to a more serious invasive infection. The risk of serious candida infection increases when multiple factors are present. These are: <a href="/wiki/Thrombocytopenia" title="Thrombocytopenia">thrombocytopenia</a>, the presence of candidal dermatitis, the use of systemic steroids, birth weights of <1,000 g, presence of a central catheter, postponing enteral feeding, vaginal delivery, and the amount of time broad-spectrum antibiotics were given.<sup id="cite_ref-Cloherty2012_23-1" class="reference"><a href="#cite_note-Cloherty2012-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Protozoans">Protozoans</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=19" title="Edit section: Protozoans"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Infants born with <a href="/wiki/Malaria" title="Malaria">malaria</a> can be infected with a variety of <a href="/wiki/Species" title="Species">species</a>; <i><a href="/wiki/Plasmodium_vivax" title="Plasmodium vivax">Plasmodium vivax</a></i>, <i><a href="/wiki/Plasmodium_malariae" title="Plasmodium malariae">Plasmodium malariae</a></i>, <i><a href="/wiki/Plasmodium_ovale" title="Plasmodium ovale">Plasmodium ovale</a></i>, and <i><a href="/wiki/Plasmodium_falciparum" title="Plasmodium falciparum">Plasmodium falciparum</a></i>. In most instances of congenital malaria is caused by <i>P. vivax</i> and <i>P. falciparum</i>. Women living in areas where malaria is prevalent and common are repeatedly exposed to malaria. In response to maternal infection, mothers develop antimalarial <a href="/wiki/Antibody" title="Antibody">antibodies</a>. It is probable that the antibodies present in the mother offers protection for the baby. Bacterial infection can develop with malaria.<sup id="cite_ref-Martin2015_22-1" class="reference"><a href="#cite_note-Martin2015-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </p><p>Infants that are infected by the protozoan <i><a href="/wiki/Toxoplasma_gondii" title="Toxoplasma gondii">Toxoplasma gondii</a></i> in utero can be born with <a href="/wiki/Chorioretinitis" title="Chorioretinitis">chorioretinitis</a> or ocular toxoplasmosis. Globally, it is the most common cause of infections of the back of the eye. (posterior segment). The most common sign is decreased vision in one eye. Other signs and symptoms may appear after the neonatal period and include: chorioretinitis development later in life, intracranial calcification hydrocephalus or central nervous system abnormalities.<sup id="cite_ref-TorgersonMastroiacovo2013_24-0" class="reference"><a href="#cite_note-TorgersonMastroiacovo2013-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Risk_factors">Risk factors</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=20" title="Edit section: Risk factors"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Preterm neonates are at greater risk of infection, including severe complications such as sepsis and meningitis. Preterm neonates usually have ineffective immune systems, due to decreased IgG antibodies and decreased complement activation. Additionally, preterm neonates require longer hospital admissions, including the placement of invasive devices that increase risk of infection.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2023)">citation needed</span></a></i>]</sup> </p><p>Maternal risk factors for neonatal infection include: </p> <ul><li><a href="/wiki/Chorioamnionitis" title="Chorioamnionitis">Chorioamnionitis</a> - acute inflammation of amniotic fluid and fetal membranes during pregnancy, usually caused by polymicrobial bacterial infection. Signs of infection include maternal fever, vaginal discharge, tender uterus or pain with urination.</li> <li><a href="/wiki/Group_B_streptococcal_infection" title="Group B streptococcal infection">GBS Colonization</a> - group B streptococcus is a bacterial pathogen commonly found in the gastrointestinal and vaginal membranes of healthy women. Presence of this bacteria is usually asymptomatic; therefore, pregnant patients will routinely be screened for presence of GBS prior to delivery.</li> <li>Delivery Before 37 Weeks - premature infants require more medical intervention and have less effective immune defenses, so these neonates are at increased risk of infection</li> <li>Prolonged Rupture of Membranes (PROM) - the amount of time between the rupture of amniotic membranes and delivery of the neonate is directly correlated with risk of neonatal infection. Prolonged course of labor increases neonatal exposure to bacterial and viral pathogens, increasing chance of infection.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Mechanism">Mechanism</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=21" title="Edit section: Mechanism"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Chorioamnionitis_-_intermed_mag.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/02/Chorioamnionitis_-_intermed_mag.jpg/220px-Chorioamnionitis_-_intermed_mag.jpg" decoding="async" width="220" height="147" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/02/Chorioamnionitis_-_intermed_mag.jpg/330px-Chorioamnionitis_-_intermed_mag.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/02/Chorioamnionitis_-_intermed_mag.jpg/440px-Chorioamnionitis_-_intermed_mag.jpg 2x" data-file-width="4272" data-file-height="2848" /></a><figcaption>Chorioamnionitis</figcaption></figure> <p>Inflammation accompanies infection and is likely to complicate <a href="/wiki/Therapy" title="Therapy">treatment</a> and recovery. Inflammation is linked to reduced growth of the <a href="/wiki/Lung" title="Lung">lungs</a> of the premature baby.<sup id="cite_ref-Pryhuber2015_26-0" class="reference"><a href="#cite_note-Pryhuber2015-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Pathogenesis">Pathogenesis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=22" title="Edit section: Pathogenesis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The recent identification of the presence of <a href="/wiki/Microorganism" title="Microorganism">microorganisms</a> in maternal-infant body fluids that were previously thought to be sterile has provided one explanation for the presence of the inflammatory response in both the mother and infant. Sixty-one percent of pregnant women with <a href="/wiki/Chorioamnionitis" title="Chorioamnionitis">chorioamnionitis</a>, or inflammation of the <a href="/wiki/Amniotic_fluid" title="Amniotic fluid">amniotic fluid</a>, were found to be infected by microorganisms. Often, <a href="/wiki/Coinfection" title="Coinfection">more than one</a> pathogen was present. In fifteen percent of pregnant women inflammation was still evident even though there was no evidence of pathogens. This may indicate that there are other causes. A high percentage, 51% to 62%, of pregnant women who had chorioamnionitis also had inflammation of the <a href="/wiki/Placenta" title="Placenta">placenta</a>.<sup id="cite_ref-Pryhuber2015_26-1" class="reference"><a href="#cite_note-Pryhuber2015-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=23" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Diagnosis" title="Diagnosis">Diagnosis</a> of infection is based upon the recovery of the pathogen or pathogens from the typically <a href="/wiki/Sterilization_(microbiology)" title="Sterilization (microbiology)">sterile</a> sites in the mother or the baby. Unfortunately, as many half of pregnant women are asymptomatic with a gonorrhea infection and other sexually transmitted infections.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Zakher_28-0" class="reference"><a href="#cite_note-Zakher-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Kenner2014_29-0" class="reference"><a href="#cite_note-Kenner2014-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> Samples are obtained from <a href="/wiki/Urine_culture" class="mw-redirect" title="Urine culture">urine</a>, <a href="/wiki/Blood_culture" title="Blood culture">blood</a> or <a href="/wiki/Cerebrospinal_fluid" title="Cerebrospinal fluid">cerebrospinal fluid</a>. Diagnosis of infection can also be aided by the use of more nonspecific tests such as determining the total <a href="/wiki/White_blood_cell" title="White blood cell">white blood cell</a> count, <a href="/wiki/Cytokine" title="Cytokine">cytokine</a> levels and other blood tests and <a href="/wiki/Medical_sign" class="mw-redirect" title="Medical sign">signs</a>.<sup id="cite_ref-Fanaroff2013_30-0" class="reference"><a href="#cite_note-Fanaroff2013-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p> <table class="wikitable"> <tbody><tr> <th>Signs of infection</th> <th>Notes</th> <th>References </th></tr> <tr> <td>abnormal <a href="/wiki/Complete_blood_count" title="Complete blood count">complete blood count</a></td> <td>looking for signs of infection<br />in the blood:<br />increased white cell count; presence of immature neutrophils</td> <td><sup id="cite_ref-SantoshamChan2013_31-0" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Sinha2012_32-0" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/C-reactive_protein" title="C-reactive protein">increased C-reactive protein</a></td> <td>a chemical in the blood that shows<br />that the baby's immune system is actively reacting<br />to infection</td> <td><sup id="cite_ref-SantoshamChan2013_31-1" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Sinha2012_32-1" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-van_de_Laarvan_der_Ham2009_33-0" class="reference"><a href="#cite_note-van_de_Laarvan_der_Ham2009-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Intercostal_muscle" class="mw-redirect" title="Intercostal muscle">accessory muscle use</a></td> <td>using the intercostal muscles to assist in<br />breathing</td> <td><sup id="cite_ref-Sinha2012_32-2" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Tachycardia" title="Tachycardia">tachycardia</a></td> <td>a <a href="/wiki/Heart_rate" title="Heart rate">heart rate</a> that is faster than normal</td> <td><sup id="cite_ref-SantoshamChan2013_31-2" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Bradycardia" title="Bradycardia">bradycardia</a></td> <td>a heart rate that is slower than normal</td> <td><sup id="cite_ref-SantoshamChan2013_31-3" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Breathing" title="Breathing">chest recession</a></td> <td></td> <td><sup id="cite_ref-Sinha2012_32-3" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Respiratory_distress" class="mw-redirect" title="Respiratory distress">respiratory distress</a></td> <td>the baby has trouble breathing</td> <td><sup id="cite_ref-SantoshamChan2013_31-4" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Sinha2012_32-4" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Nasal_flaring" class="mw-redirect" title="Nasal flaring">nasal flaring</a></td> <td>the baby's nostrils expand<br />when it inhales</td> <td><sup id="cite_ref-Sinha2012_32-5" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>expiratory grunt</td> <td>a sound of effort when the baby exhales</td> <td><sup id="cite_ref-Sinha2012_32-6" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Apnea" title="Apnea">apnea</a></td> <td>the baby stops breathing</td> <td><sup id="cite_ref-SantoshamChan2013_31-5" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Sinha2012_32-7" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>rash</td> <td></td> <td><sup id="cite_ref-Sinha2012_32-8" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>positive urine culture</td> <td></td> <td><sup id="cite_ref-SantoshamChan2013_31-6" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>positive cerebral spinal fluid</td> <td></td> <td><sup id="cite_ref-SantoshamChan2013_31-7" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>other positive cultures</td> <td>from eyes, ear canal, umbilicus<br />axilla anus</td> <td><sup id="cite_ref-SantoshamChan2013_31-8" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Lethargy" title="Lethargy">lethargy</a></td> <td>the baby seems tired and has slow or no movements</td> <td><sup id="cite_ref-SantoshamChan2013_31-9" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Sinha2012_32-9" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Hypotonia" title="Hypotonia">hypotonia</a></td> <td>the muscles seem flabby and weak</td> <td><sup id="cite_ref-SantoshamChan2013_31-10" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Sinha2012_32-10" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>hypothermia</td> <td></td> <td><sup id="cite_ref-SantoshamChan2013_31-11" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Irritation" title="Irritation">irritability</a></td> <td>infant appears uncomfortable and<br />has difficulty being soothed</td> <td><sup id="cite_ref-SantoshamChan2013_31-12" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Sinha2012_32-11" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>weak cry</td> <td></td> <td><sup id="cite_ref-Sinha2012_32-12" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>pneumonia</td> <td></td> <td><sup id="cite_ref-SantoshamChan2013_31-13" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>poor perfusion</td> <td>poor circulation</td> <td><sup id="cite_ref-SantoshamChan2013_31-14" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Sinha2012_32-13" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Hypotension" title="Hypotension">hypotension</a></td> <td>low blood pressure</td> <td><sup id="cite_ref-Sinha2012_32-14" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Acidosis" title="Acidosis">acidosis</a></td> <td>pH imbalance in the blood</td> <td><sup id="cite_ref-SantoshamChan2013_31-15" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Sinha2012_32-15" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a></td> <td>water-like, unformed stools</td> <td><sup id="cite_ref-Sinha2012_32-16" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>poor feeding</td> <td></td> <td><sup id="cite_ref-SantoshamChan2013_31-16" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>oxygen requirement</td> <td></td> <td><sup id="cite_ref-SantoshamChan2013_31-17" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>bulging <a href="/wiki/Fontanel" class="mw-redirect" title="Fontanel">fontanel</a></td> <td>the soft spot on the head is bulging</td> <td><sup id="cite_ref-Sinha2012_32-17" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Seizure" title="Seizure">seizures</a></td> <td></td> <td><sup id="cite_ref-SantoshamChan2013_31-18" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Sinha2012_32-18" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>fever</td> <td></td> <td><sup id="cite_ref-SantoshamChan2013_31-19" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Disseminated_intravascular_coagulation" title="Disseminated intravascular coagulation">disseminated intravascular coagulation</a></td> <td>widespread clotting of blood</td> <td><sup id="cite_ref-Sinha2012_32-19" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td><a href="/wiki/Kidney_failure" title="Kidney failure">kidney failure</a></td> <td>kidneys do not function</td> <td><sup id="cite_ref-Sinha2012_32-20" class="reference"><a href="#cite_note-Sinha2012-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td>bacteremia</td> <td>bacteria cultured from the blood<br />of the newborn</td> <td><sup id="cite_ref-SantoshamChan2013_31-20" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </td></tr></tbody></table> <div class="mw-heading mw-heading3"><h3 id="Viral_infection">Viral infection</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=24" title="Edit section: Viral infection"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Symptoms and the isolation of the virus pathogen the upper respiratory tract is diagnostic. Virus identification is specific immunologic methods and PCR. The presence of the virus can be rapidly confirmed by the detection of the virus antigen. The methods and materials used for identifying the RSV virus has a specificity and sensitivity approaching 85% to 95%. Not all studies confirm this sensitivity. Antigen detection has comparatively lower sensitivity rates that approach 65% to 75%.<sup id="cite_ref-Mayhall2012_35-0" class="reference"><a href="#cite_note-Mayhall2012-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Protozoan_infection">Protozoan infection</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=25" title="Edit section: Protozoan infection"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Congential malaria has its own set of signs: </p> <table class="wikitable"> <tbody><tr> <th>Signs of congenital malaria infection</th> <th>Notes</th> <th>References </th></tr> <tr> <td>splenomegaly</td> <td>enlarged speen</td> <td> </td></tr> <tr> <td>fever</td> <td></td> <td> </td></tr> <tr> <td>anemia</td> <td></td> <td> </td></tr> <tr> <td>jaundice</td> <td></td> <td> </td></tr> <tr> <td>poor feeding</td> <td></td> <td> </td></tr> <tr> <td>hepatomegaly</td> <td>enlarged liver</td> <td> </td></tr> <tr> <td>failure to thrive</td> <td></td> <td> </td></tr> <tr> <td>loose stools</td> <td></td> <td> </td></tr> <tr> <td>irritability</td> <td></td> <td> </td></tr> <tr> <td>hyperbilirubinemia</td> <td></td> <td> </td></tr> <tr> <td>central nervous system infection</td> <td></td> <td> </td></tr> <tr> <td>splenic rupture</td> <td></td> <td> </td></tr> <tr> <td>kidney failure</td> <td></td> <td> </td></tr> <tr> <td>blackwater fever</td> <td>infection with<br /><i>P. falciparum</i> only</td> <td><sup id="cite_ref-Martin2015_22-2" class="reference"><a href="#cite_note-Martin2015-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </td></tr> <tr> <td></td> <td></td> <td> </td></tr></tbody></table> <div class="mw-heading mw-heading3"><h3 id="Neonatal_sepsis">Neonatal sepsis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=26" title="Edit section: Neonatal sepsis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Neonatal_sepsis" title="Neonatal sepsis">Neonatal sepsis</a></div> <p>Neonatal sepsis of the newborn is an infection that has spread through the entire body. The inflammatory response to this systematic infection can be as serious as the infection itself.<sup id="cite_ref-Pryhuber2015_26-2" class="reference"><a href="#cite_note-Pryhuber2015-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> In infants that weigh under 1500 g, <a href="/wiki/Sepsis" title="Sepsis">sepsis</a> is the most common cause of death. Three to four percent of infants per 1000 births contract sepsis. The mortality rate from sepsis is near 25%.<sup id="cite_ref-Florin2011_36-0" class="reference"><a href="#cite_note-Florin2011-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> Infected sepsis in an infant can be identified by culturing the blood and spinal fluid and if suspected, intravenous antibiotics are usually started. Lumbar puncture is controversial because in some cases it has found not to be necessary while concurrently, without it estimates of missing up to one third of infants with meningitis is predicted.<sup id="cite_ref-Fanaroff2013_30-1" class="reference"><a href="#cite_note-Fanaroff2013-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=27" title="Edit section: Prevention"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>To reduce neonatal infection, screening of pregnant women for HIV, hepatitis B, and syphilis, is available in the UK and the United States.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> </p><p>Treatment with a vaginal antibiotic wash prior to birth does not prevent infection with group B streptococcus bacteria (GBS).<sup id="cite_ref-SantoshamChan2013_31-21" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-OhlssonShah2014_39-0" class="reference"><a href="#cite_note-OhlssonShah2014-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> Treatment with vaginal chlorhexidine prior to birth does not prevent neonatal infections.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> </p><p>Because GBS bacteria can colonize the lower reproductive tract of 30% of women, typically pregnant women are tested for this pathogen from 35 to 37 weeks of pregnancy. Before delivery treatment of the mother with antibiotics reduces the rate of neonatal infection.<sup id="cite_ref-SantoshamChan2013_31-22" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> Prevention of the infection of the baby is done by treating the mother with penicillin. Since the adoption of this prophylactic treatment, infant mortality from GBS infection has decreased by 80%.<sup id="cite_ref-Florin2011_36-1" class="reference"><a href="#cite_note-Florin2011-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> </p><p>Mothers with symptomatic <a href="/wiki/Herpes_simplex_virus" title="Herpes simplex virus">genital herpes</a> and who are treated with antiviral prophylaxis are less prone to have an active, symptomatic case at the time of birth and it may be able to reduce the risk of passing on HSV during birth. Cesarean delivery reduces the risk of infection of the infant.<sup id="cite_ref-HollierWendel2008_41-0" class="reference"><a href="#cite_note-HollierWendel2008-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Breastfeeding" title="Breastfeeding">Breastfeeding</a> has been shown to protect the neonate from some infections.<sup id="cite_ref-pmid10394490_42-0" class="reference"><a href="#cite_note-pmid10394490-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid10394491_43-0" class="reference"><a href="#cite_note-pmid10394491-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-CDC_45-0" class="reference"><a href="#cite_note-CDC-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Immune_46-0" class="reference"><a href="#cite_note-Immune-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> <sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citing_sources#Bundling_citations" title="Wikipedia:Citing sources"><span title="This claim has too many footnotes for reading to be smooth. (September 2020)">excessive citations</span></a></i>]</sup> Breast milk protects against necrotizing <a href="/wiki/Enterocolitis" title="Enterocolitis">enterocolitis</a>.<sup id="cite_ref-Isaacs2014_47-0" class="reference"><a href="#cite_note-Isaacs2014-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> </p><p>Hepatitis A, B, and D are preventable via vaccination. Hepatitis A can be prevented by immunization against HAV, while Hepatitis B and D can both be prevented by immunization against HBV.<sup id="cite_ref-:1_20-6" class="reference"><a href="#cite_note-:1-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p><p>The Hepatitis B vaccination is among the first two injections a newborn receives.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> The other is vitamin K to prevent <a href="/wiki/Vitamin_K_deficiency_bleeding" title="Vitamin K deficiency bleeding">vitamin K deficiency bleeding</a>.<sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> In cases where the pregnant woman is positive for hepatitis B, the baby will receive an additional dose of hepatitis B immunoglobulin in addition to the hepatitis B vaccine to prevent transmission of the disease from mother to baby.<sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> Prevention of hepatitis B is crucial as there is no currently no cure.<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> </p><p>In general, in an unvaccinated individual, the viral hepatitis family causes liver damage due to a cell-mediated response via cytotoxic lymphocytes.<sup id="cite_ref-:2_52-0" class="reference"><a href="#cite_note-:2-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> Acute viral hepatitis can lead to jaundice, elevated bilirubin, elevated liver enzymes (aspartate transaminase, alanine transaminase, and alkaline phosphatase), and flu-like symptoms.<sup id="cite_ref-:2_52-1" class="reference"><a href="#cite_note-:2-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> Importantly, acute neonatal HBV infections progress to chronic Hepatitis B about 90% of the time.<sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup> For both Hepatitis B and Hepatitis D, the most significant long-term complications are progression to cirrhosis and hepatocellular carcinoma, which carries high morbidity and mortality.<sup id="cite_ref-54" class="reference"><a href="#cite_note-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=28" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Neonatal infection treatment is typically started before the diagnosis of the cause can be confirmed. Neonatal infection can be prophylactically treated with antibiotics.<sup id="cite_ref-MacDonald2015_55-0" class="reference"><a href="#cite_note-MacDonald2015-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> Maternal treatment with antibiotics is primarily used to protect against group B streptococcus.<sup id="cite_ref-Fanaroff2013_30-2" class="reference"><a href="#cite_note-Fanaroff2013-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p><p>Women with a history of <a href="/wiki/Herpes_simplex_virus" title="Herpes simplex virus">genital herpes</a>, can be treated with antiviral drugs to prevent symptomatic lesions and viral shedding that could infect the infant at birth. The antiviral medications used include acyclovir, penciclovir, valacyclovir, and famciclovir. Only very small amounts of the drug can be detected in the fetus. There are no increases in drug-related abnormalities in the infant that could be attributed to acyclovir. Long-term effects of antiviral medications have not been evaluated for their effects after growth and development of the child occurs. Neutropenia can be a complication of acyclovir treatment of neonatal HSV infection, but is usually transient.<sup id="cite_ref-HollierWendel2008_41-1" class="reference"><a href="#cite_note-HollierWendel2008-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> Treatment with immunoglobulin therapy has not been proven to be effective and is not recommended.<sup id="cite_ref-56" class="reference"><a href="#cite_note-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=29" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Perinatal_mortality" title="Perinatal mortality">Perinatal mortality</a></div> <p>Up to 3.3 million newborns die each year and 23.4% of these die of neonatal infection. About half of the deaths caused by sepsis or pneumonia happen in the first week postpartum. In industrialized countries, prophylactic antibiotic treatment of the mothers identified with group B streptococcus, early identification of sepsis in the newborn, and administration of antibiotics to the newborn has reduced mortality.<sup id="cite_ref-SantoshamChan2013_31-23" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> Neonatal herpes in North America is estimated to be from 5 – 80 per 100,000 live births. HSV has a lower prevalence in mothers outside the United States. In the United Kingdom the incidence is much lower and estimated to be 1.6 per 100,000 live births. Approximately 70% to 80% of infected infants are born to mothers with no reported history of HSV infection.<sup id="cite_ref-HollierWendel2008_41-2" class="reference"><a href="#cite_note-HollierWendel2008-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> </p><p>Regions with low neonatal mortality include Europe, the Western Pacific, and the Americas, which have sepsis rates that account for 9.1% to 15.3% of the total neonatal deaths worldwide. This is in contrast with the 22.5 to 27.2% percentage of total deaths in resource-poor countries such as Nigeria, the Democratic Republic of the Congo, India, Pakistan, and China.<sup id="cite_ref-SantoshamChan2013_31-24" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </p><p>In the UK, the proportions of pregnant women who are newly screened positive for hepatitis B, syphilis, and HIV have remained constant since 2010 at about 0.4%, 0.14% and 0.15%, respectively. Estimated prevalence levels among pregnant women for hepatitis B and HIV, including previous diagnoses, were higher at 0.67% and 0.27%. Pregnant women evaluated as susceptible to rubella due to low antibody levels have increased by over 60%, to about 7.2%. However, this increase is probably due to changes in testing methods and evaluation criteria.<sup id="cite_ref-GB2014_57-0" class="reference"><a href="#cite_note-GB2014-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup> </p><p>In North America, prior to the 1950s, group A β-hemolytic streptococcus (GAS) was the most common pathogen associated with neonatal sepsis prior to the 1960s. In the past twenty years, the most common pathogen causing sepsis is coagulase-negative staphylococci that exist as biofilms associated with infected central venous or arterial catheters.<sup id="cite_ref-MacDonald2015_55-1" class="reference"><a href="#cite_note-MacDonald2015-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> Infections can be fatal and contribute to long-term morbidity and disability among the infants who survive into childhood.<sup id="cite_ref-MacDonald2015_55-2" class="reference"><a href="#cite_note-MacDonald2015-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup> Neonatal sepsis effects 128 cases per 1000 live births. Meningitis can occur in the septic infant.<sup id="cite_ref-Fanaroff2013_30-3" class="reference"><a href="#cite_note-Fanaroff2013-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> Expectant mothers with HSV have a 75% chance of at least one flare-up during their pregnancy.<sup id="cite_ref-HollierWendel2008_41-3" class="reference"><a href="#cite_note-HollierWendel2008-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> In limited studies it was found that infants in Africa born to mothers with malaria have a 7% of acquiring congenital malaria.<sup id="cite_ref-Martin2015_22-3" class="reference"><a href="#cite_note-Martin2015-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Early-onset_infections">Early-onset infections</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=30" title="Edit section: Early-onset infections"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Early onset sepsis can occur in the first week of life. It usually is apparent on the first day after birth. This type of infection is usually acquired before the birth of the infant. <a href="/wiki/Premature_rupture_of_membranes" class="mw-redirect" title="Premature rupture of membranes">Premature rupture of membranes</a> and other <a href="/wiki/Obstetric_labor_complication" title="Obstetric labor complication">obstetrical complications</a> can add to the risk of early-onset sepsis. If the amniotic membrane has been ruptured greater than 18 hours before delivery the infant may be at more risk for this complication. Prematurity, low birth weight, chorioamnionitis, maternal urinary tract infection and/or maternal fever are complications that increase the risk for early-onset sepsis. Early onset sepsis is indicated by serious respiratory symptoms. The infant usually develops pneumonia, hypothermia, or shock. The mortality rate is 30 to 50%.<sup id="cite_ref-Fanaroff2013_30-4" class="reference"><a href="#cite_note-Fanaroff2013-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Late_onset_infections">Late onset infections</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=31" title="Edit section: Late onset infections"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Infections that occur after the first week of life but before the age of 30 days are considered late onset infections. Obstetrical and maternal complications are not typically the cause of these late onset infections; they are usually acquired by the infant in the hospital neonatal intensive care unit. The widespread use of broad-spectrum antibiotics in the nursery intensive care unit can cause a higher prevalence of invasive antibiotic resistant bacteria.<sup id="cite_ref-Fanaroff2013_30-5" class="reference"><a href="#cite_note-Fanaroff2013-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> Meconium aspiration syndrome has a mortality rate just over 4%. This accounts for 2% for all neonatal deaths.<sup id="cite_ref-SiriwachirachaiSangkomkamhang2014_58-0" class="reference"><a href="#cite_note-SiriwachirachaiSangkomkamhang2014-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=32" title="Edit section: Research"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The susceptibility to risk of infection and immune deficiencies are active areas of research. Studies regarding the role of viruses in neonatal infections are lacking. Research also continues into the role and protective effect of gut, skin and other human microbiomes and the colonization during the neonatal period.<sup id="cite_ref-Pryhuber2015_26-3" class="reference"><a href="#cite_note-Pryhuber2015-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Fanaroff2013_30-6" class="reference"><a href="#cite_note-Fanaroff2013-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> The comparison between both resource rich and poor countries makes it difficult to compare the diagnosis success; as industrialized regions are able to confirm the diagnosis and presence of pathogens in the clinical laboratory. Clinical testing may not be available in all settings and clinicians must rely on the signs of infection in the newborn. Research data from Africa and Southeast Asia is scarce.<sup id="cite_ref-SantoshamChan2013_31-25" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </p><p>The result of some research has been the identification of diagnostic tools and procedures that could identify mothers with group B streptococcus infection in resource-poor regions. These procedures would be easy and inexpensive to use. Those mothers who are identified as being infected could then be prophylactly treated prior to the birth of the baby.<sup id="cite_ref-SantoshamChan2013_31-26" class="reference"><a href="#cite_note-SantoshamChan2013-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </p><p>Probiotic administration of Lactobacillus species has shown some success.<sup id="cite_ref-BaucellsMercadal_Hally2015_59-0" class="reference"><a href="#cite_note-BaucellsMercadal_Hally2015-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup> </p><p>A GBS vaccine is currently being tested but not currently available. Vaccination is estimated to being able to prevent 4% of GBS infections for preterm births and 60–70% for neonatal GBS infections in the US. The projected benefits of maternal vaccination is the prevention of 899 cases of GBS disease and 35 deaths among infants. The cost savings in the prevention of GBS may be over 43 million dollars. Vaccination may be especially beneficial in low to middle income countries where screening and prophylactic treatment is not possible. Analysts project that GBS vaccination would prevent 30–54% of infant GBS cases. Screening, prophylactic antibiotics and vaccine would prevent 48% of infection.<sup id="cite_ref-CorteseScicchitano2015_60-0" class="reference"><a href="#cite_note-CorteseScicchitano2015-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=33" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Preterm_birth" title="Preterm birth">Preterm birth</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=34" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text">Neil K. Kaneshiro; David Zieve; Isla Ogilvie, eds. (December 4, 2013). "Neonate". U.S. National Library of Medicine. Retrieved January 16, 2016.</span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text">Mary T. Caserta (October 2015). "Overview of Neonatal Infections". Merck Sharp & Dohme Corporation. 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<a href="#cite_ref-SantoshamChan2013_31-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-16"><sup><i><b>q</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-17"><sup><i><b>r</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-18"><sup><i><b>s</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-19"><sup><i><b>t</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-20"><sup><i><b>u</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-21"><sup><i><b>v</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-22"><sup><i><b>w</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-23"><sup><i><b>x</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-24"><sup><i><b>y</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-25"><sup><i><b>z</b></i></sup></a> <a href="#cite_ref-SantoshamChan2013_31-26"><sup><i><b>aa</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSantoshamChanLeeBaqui2013" class="citation journal cs1">Santosham M, Chan GJ, Lee AC, Baqui AH, Tan J, Black RE (2013). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747995">"Risk of Early-Onset Neonatal Infection with Maternal Infection or Colonization: A Global Systematic Review and Meta-Analysis"</a>. <i>PLOS Medicine</i>. <b>10</b> (8): e1001502. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1371%2Fjournal.pmed.1001502">10.1371/journal.pmed.1001502</a></span>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1549-1676">1549-1676</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747995">3747995</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23976885">23976885</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=PLOS+Medicine&rft.atitle=Risk+of+Early-Onset+Neonatal+Infection+with+Maternal+Infection+or+Colonization%3A+A+Global+Systematic+Review+and+Meta-Analysis&rft.volume=10&rft.issue=8&rft.pages=e1001502&rft.date=2013&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3747995%23id-name%3DPMC&rft.issn=1549-1676&rft_id=info%3Apmid%2F23976885&rft_id=info%3Adoi%2F10.1371%2Fjournal.pmed.1001502&rft.aulast=Santosham&rft.aufirst=Mathuram&rft.au=Chan%2C+Grace+J.&rft.au=Lee%2C+Anne+CC&rft.au=Baqui%2C+Abdullah+H.&rft.au=Tan%2C+Jingwen&rft.au=Black%2C+Robert+E.&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3747995&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANeonatal+infection" class="Z3988"></span></span> </li> <li id="cite_note-Sinha2012-32"><span class="mw-cite-backlink">^ <a href="#cite_ref-Sinha2012_32-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-16"><sup><i><b>q</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-17"><sup><i><b>r</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-18"><sup><i><b>s</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-19"><sup><i><b>t</b></i></sup></a> <a href="#cite_ref-Sinha2012_32-20"><sup><i><b>u</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSinhaMiallJardine2012" class="citation book cs1">Sinha S, Miall L, Jardine L (2012). <i>Essential neonatal medicine</i> (5th ed.). Wiley. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-470-67040-8" title="Special:BookSources/978-0-470-67040-8"><bdi>978-0-470-67040-8</bdi></a>. <a href="/wiki/OCLC_(identifier)" class="mw-redirect" title="OCLC (identifier)">OCLC</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/oclc/827207710">827207710</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Essential+neonatal+medicine&rft.edition=5th&rft.pub=Wiley&rft.date=2012&rft_id=info%3Aoclcnum%2F827207710&rft.isbn=978-0-470-67040-8&rft.aulast=Sinha&rft.aufirst=Sunil&rft.au=Miall%2C+Lawrence&rft.au=Jardine%2C+Luke&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANeonatal+infection" class="Z3988"></span></span> </li> <li id="cite_note-van_de_Laarvan_der_Ham2009-33"><span class="mw-cite-backlink"><b><a href="#cite_ref-van_de_Laarvan_der_Ham2009_33-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFvan_de_Laarvan_der_HamOeiWillekes2009" class="citation journal cs1">van de Laar R, van der Ham DP, Oei SG, Willekes C, Weiner CP, Mol BW (2009). "Accuracy of C-reactive protein determination in predicting chorioamnionitis and neonatal infection in pregnant women with premature rupture of membranes: A systematic review". <i>European Journal of Obstetrics & Gynecology and Reproductive Biology</i>. <b>147</b> (2): 124–129. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.ejogrb.2009.09.017">10.1016/j.ejogrb.2009.09.017</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0301-2115">0301-2115</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19819609">19819609</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=European+Journal+of+Obstetrics+%26+Gynecology+and+Reproductive+Biology&rft.atitle=Accuracy+of+C-reactive+protein+determination+in+predicting+chorioamnionitis+and+neonatal+infection+in+pregnant+women+with+premature+rupture+of+membranes%3A+A+systematic+review&rft.volume=147&rft.issue=2&rft.pages=124-129&rft.date=2009&rft.issn=0301-2115&rft_id=info%3Apmid%2F19819609&rft_id=info%3Adoi%2F10.1016%2Fj.ejogrb.2009.09.017&rft.aulast=van+de+Laar&rft.aufirst=Rafli&rft.au=van+der+Ham%2C+David+P.&rft.au=Oei%2C+S.+Guid&rft.au=Willekes%2C+Christine&rft.au=Weiner%2C+Carl+P.&rft.au=Mol%2C+Ben+W.J.&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANeonatal+infection" class="Z3988"></span></span> </li> <li id="cite_note-34"><span class="mw-cite-backlink"><b><a href="#cite_ref-34">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.gpnotebook.co.uk/simplepage.cfm?ID=-328531926">"Grunting in Neonates - General Practice Notebook"</a>. <i>www.gpnotebook.co.uk</i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=www.gpnotebook.co.uk&rft.atitle=Grunting+in+Neonates+-+General+Practice+Notebook&rft_id=https%3A%2F%2Fwww.gpnotebook.co.uk%2Fsimplepage.cfm%3FID%3D-328531926&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANeonatal+infection" class="Z3988"></span> <span style="font-size:0.95em; font-size:95%; color: var( --color-subtle, #555 )">(subscription required)</span></span> </li> <li id="cite_note-Mayhall2012-35"><span class="mw-cite-backlink"><b><a href="#cite_ref-Mayhall2012_35-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMayhall2012" class="citation book cs1">Mayhall CG (2012). <i>Hospital epidemiology and infection control</i> (4th ed.). 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A Review"</a>. <i>Pediatrics & Neonatology</i>. <b>57</b> (4): 265–273. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.pedneo.2015.09.007">10.1016/j.pedneo.2015.09.007</a></span>. <a href="/wiki/Hdl_(identifier)" class="mw-redirect" title="Hdl (identifier)">hdl</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://hdl.handle.net/11586%2F219777">11586/219777</a></span>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1875-9572">1875-9572</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26750406">26750406</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Pediatrics+%26+Neonatology&rft.atitle=Early+and+Late+Infections+in+Newborns%3A+Where+Do+We+Stand%3F+A+Review&rft.volume=57&rft.issue=4&rft.pages=265-273&rft.date=2015&rft_id=info%3Ahdl%2F11586%2F219777&rft.issn=1875-9572&rft_id=info%3Apmid%2F26750406&rft_id=info%3Adoi%2F10.1016%2Fj.pedneo.2015.09.007&rft.aulast=Cortese&rft.aufirst=Francesca&rft.au=Scicchitano%2C+Pietro&rft.au=Gesualdo%2C+Michele&rft.au=Filaninno%2C+Antonella&rft.au=De+Giorgi%2C+Elsa&rft.au=Schettini%2C+Federico&rft.au=Laforgia%2C+Nicola&rft.au=Ciccone%2C+Marco+Matteo&rft_id=http%3A%2F%2Fwww.pediatr-neonatol.com%2Farticle%2FS1875-9572%252815%252900175-8%2Ffulltext%23sec4&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANeonatal+infection" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=35" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239549316">.mw-parser-output .refbegin{margin-bottom:0.5em}.mw-parser-output .refbegin-hanging-indents>ul{margin-left:0}.mw-parser-output .refbegin-hanging-indents>ul>li{margin-left:0;padding-left:3.2em;text-indent:-3.2em}.mw-parser-output .refbegin-hanging-indents ul,.mw-parser-output .refbegin-hanging-indents ul li{list-style:none}@media(max-width:720px){.mw-parser-output .refbegin-hanging-indents>ul>li{padding-left:1.6em;text-indent:-1.6em}}.mw-parser-output .refbegin-columns{margin-top:0.3em}.mw-parser-output .refbegin-columns ul{margin-top:0}.mw-parser-output .refbegin-columns li{page-break-inside:avoid;break-inside:avoid-column}@media screen{.mw-parser-output .refbegin{font-size:90%}}</style><div class="refbegin" style=""> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFJensterBonifacioRuelRogers2014" class="citation journal cs1">Jenster M, Bonifacio SL, Ruel T, Rogers EE, Tam EW, Partridge JC, Barkovich AJ, Ferriero DM, Glass HC (2014-07-01). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062582">"Maternal or neonatal infection: association with neonatal encephalopathy outcomes"</a>. <i>Pediatric Research</i>. <b>76</b> (1): 93–99. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fpr.2014.47">10.1038/pr.2014.47</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0031-3998">0031-3998</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062582">4062582</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24713817">24713817</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Pediatric+Research&rft.atitle=Maternal+or+neonatal+infection%3A+association+with+neonatal+encephalopathy+outcomes&rft.volume=76&rft.issue=1&rft.pages=93-99&rft.date=2014-07-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4062582%23id-name%3DPMC&rft.issn=0031-3998&rft_id=info%3Apmid%2F24713817&rft_id=info%3Adoi%2F10.1038%2Fpr.2014.47&rft.aulast=Jenster&rft.aufirst=Meike&rft.au=Bonifacio%2C+Sonia+L.&rft.au=Ruel%2C+Theodore&rft.au=Rogers%2C+Elizabeth+E.&rft.au=Tam%2C+Emily+W.&rft.au=Partridge%2C+John+Colin&rft.au=Barkovich%2C+A.+James&rft.au=Ferriero%2C+Donna+M.&rft.au=Glass%2C+Hannah+C.&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4062582&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANeonatal+infection" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20160106081648/http://www.guideline.gov/content.aspx?id=38408">"Antibiotics for the prevention and treatment of early-onset neonatal infection"</a>. National Guideline Clearinghouse. Archived from <a rel="nofollow" class="external text" href="https://www.guideline.gov/content.aspx?id=38408">the original</a> on 2016-01-06<span class="reference-accessdate">. Retrieved <span class="nowrap">2016-01-15</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Antibiotics+for+the+prevention+and+treatment+of+early-onset+neonatal+infection&rft.pub=National+Guideline+Clearinghouse&rft_id=https%3A%2F%2Fwww.guideline.gov%2Fcontent.aspx%3Fid%3D38408&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANeonatal+infection" class="Z3988"></span></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Neonatal_infection&action=edit&section=36" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.who.int/pmnch/media/press_materials/fs/fs_newborndealth_illness/en/">"Newborn death and illness"</a>. <a href="/wiki/World_Health_Organization" title="World Health Organization">World Health Organization</a><span class="reference-accessdate">. Retrieved <span class="nowrap">2016-01-15</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Newborn+death+and+illness&rft.pub=World+Health+Organization&rft_id=https%3A%2F%2Fwww.who.int%2Fpmnch%2Fmedia%2Fpress_materials%2Ffs%2Ffs_newborndealth_illness%2Fen%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ANeonatal+infection" class="Z3988"></span></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol 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.navbox{display:none!important}}</style></div><div role="navigation" class="navbox" aria-labelledby="Conditions_originating_in_the_perinatal_period_/_fetal_disease" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar 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href="/wiki/Template_talk:Pediatric_conditions_originating_in_the_perinatal_period" title="Template talk:Pediatric conditions originating in the perinatal period"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Pediatric_conditions_originating_in_the_perinatal_period" title="Special:EditPage/Template:Pediatric conditions originating in the perinatal period"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Conditions_originating_in_the_perinatal_period_/_fetal_disease" style="font-size:114%;margin:0 4em">Conditions originating in the <a href="/wiki/Perinatal" class="mw-redirect" title="Perinatal">perinatal</a> period / <a href="/wiki/Fetal_disease" class="mw-redirect" title="Fetal disease">fetal disease</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Maternal factors <br /> complicating pregnancy,<br /> labour or delivery</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i><a href="/wiki/Placental_disease" title="Placental disease">placenta</a></i></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Placenta_praevia" title="Placenta praevia">Placenta praevia</a></li> <li><a href="/wiki/Placental_insufficiency" title="Placental insufficiency">Placental insufficiency</a></li> <li><a href="/wiki/Twin-to-twin_transfusion_syndrome" title="Twin-to-twin transfusion syndrome">Twin-to-twin transfusion syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i><a href="/wiki/Chorion" title="Chorion">chorion</a>/<a href="/wiki/Amnion" title="Amnion">amnion</a></i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chorioamnionitis" title="Chorioamnionitis">Chorioamnionitis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i><a href="/wiki/Umbilical_cord#Problems_and_abnormalities" title="Umbilical cord">umbilical cord</a></i></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Umbilical_cord_prolapse" title="Umbilical cord prolapse">Umbilical cord prolapse</a></li> <li><a href="/wiki/Nuchal_cord" title="Nuchal cord">Nuchal cord</a></li> <li><a href="/wiki/Single_umbilical_artery" title="Single umbilical artery">Single umbilical artery</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><span class="nobold"><i><a href="/wiki/Presentation_(obstetrics)" title="Presentation (obstetrics)">presentation</a></i></span></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Breech_birth" title="Breech birth">Breech birth</a></li> <li><a href="/wiki/Asynclitic_birth" title="Asynclitic birth">Asynclitism</a></li> <li><a href="/wiki/Shoulder_presentation" title="Shoulder presentation">Shoulder presentation</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Growth</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Small_for_gestational_age" title="Small for gestational age">Small for gestational age</a> / <a href="/wiki/Large_for_gestational_age" title="Large for gestational age">Large for gestational age</a></li> <li><a href="/wiki/Preterm_birth" title="Preterm birth">Preterm birth</a> / <a href="/wiki/Postterm_pregnancy" title="Postterm pregnancy">Postterm pregnancy</a></li> <li><a href="/wiki/Intrauterine_growth_restriction" title="Intrauterine growth restriction">Intrauterine growth restriction</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Birth_trauma_(physical)" title="Birth trauma (physical)">Birth trauma</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Scalp" title="Scalp">scalp</a></i> <ul><li><a href="/wiki/Cephalohematoma" title="Cephalohematoma">Cephalohematoma</a></li> <li><a href="/wiki/Chignon_(medical_term)" title="Chignon (medical term)">Chignon</a></li> <li><a href="/wiki/Caput_succedaneum" title="Caput succedaneum">Caput succedaneum</a></li> <li><a href="/wiki/Subgaleal_hemorrhage" title="Subgaleal hemorrhage">Subgaleal hemorrhage</a></li></ul></li> <li><a href="/wiki/Brachial_plexus_injury" title="Brachial plexus injury">Brachial plexus injury</a> <ul><li><a href="/wiki/Erb%27s_palsy" title="Erb's palsy">Erb's palsy</a></li> <li><a href="/wiki/Klumpke_paralysis" title="Klumpke paralysis">Klumpke paralysis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Affected systems</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Respiratory_disease" title="Respiratory disease">Respiratory</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Intrauterine_hypoxia" title="Intrauterine hypoxia">Intrauterine hypoxia</a></li> <li><a href="/wiki/Infant_respiratory_distress_syndrome" title="Infant respiratory distress syndrome">Infant respiratory distress syndrome</a></li> <li><a href="/wiki/Transient_tachypnea_of_the_newborn" title="Transient tachypnea of the newborn">Transient tachypnea of the newborn</a></li> <li><a href="/wiki/Meconium_aspiration_syndrome" title="Meconium aspiration syndrome">Meconium aspiration syndrome</a></li> <li><i><a href="/wiki/Pleural_disease" title="Pleural disease">Pleural disease</a></i> <ul><li><a href="/wiki/Pneumothorax" title="Pneumothorax">Pneumothorax</a></li> <li><a href="/wiki/Pneumomediastinum" title="Pneumomediastinum">Pneumomediastinum</a></li></ul></li> <li><a href="/wiki/Wilson%E2%80%93Mikity_syndrome" title="Wilson–Mikity syndrome">Wilson–Mikity syndrome</a></li> <li><a href="/wiki/Bronchopulmonary_dysplasia" title="Bronchopulmonary dysplasia">Bronchopulmonary dysplasia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cardiovascular_disease" title="Cardiovascular disease">Cardiovascular</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pneumopericardium" title="Pneumopericardium">Pneumopericardium</a></li> <li><a href="/wiki/Persistent_fetal_circulation" title="Persistent fetal circulation">Persistent fetal circulation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Bleeding" title="Bleeding">Bleeding</a> and<br /><a href="/wiki/Hematologic_disease" title="Hematologic disease">hematologic disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Vitamin_K_deficiency_bleeding" title="Vitamin K deficiency bleeding">Vitamin K deficiency bleeding</a></li></ul> <ul><li><a href="/wiki/Hemolytic_disease_of_the_newborn" title="Hemolytic disease of the newborn">HDN</a> <ul><li><a href="/wiki/Hemolytic_disease_of_the_newborn_(ABO)" title="Hemolytic disease of the newborn (ABO)">ABO</a></li> <li><a href="/wiki/Hemolytic_disease_of_the_newborn_(anti-Kell)" title="Hemolytic disease of the newborn (anti-Kell)">Anti-Kell</a></li> <li><a href="/wiki/Hemolytic_disease_of_the_newborn_(anti-Rhc)" title="Hemolytic disease of the newborn (anti-Rhc)">Rh c</a></li> <li><a href="/wiki/Rh_disease" title="Rh disease">Rh D</a></li> <li><a href="/wiki/Hemolytic_disease_of_the_newborn_(anti-RhE)" title="Hemolytic disease of the newborn (anti-RhE)">Rh E</a></li></ul></li> <li><a href="/wiki/Hydrops_fetalis" title="Hydrops fetalis">Hydrops fetalis</a></li> <li><a href="/wiki/Hyperbilirubinemia" class="mw-redirect" title="Hyperbilirubinemia">Hyperbilirubinemia</a> <ul><li><a href="/wiki/Kernicterus" title="Kernicterus">Kernicterus</a></li> <li><a href="/wiki/Neonatal_jaundice" title="Neonatal jaundice">Neonatal jaundice</a></li></ul></li></ul> <ul><li><a href="/wiki/Velamentous_cord_insertion" title="Velamentous cord insertion">Velamentous cord insertion</a></li> <li><a href="/wiki/Intraventricular_hemorrhage" title="Intraventricular hemorrhage">Intraventricular hemorrhage</a> <ul><li><a href="/wiki/Germinal_matrix_hemorrhage" title="Germinal matrix hemorrhage">Germinal matrix hemorrhage</a></li></ul></li> <li><a href="/wiki/Anemia_of_prematurity" title="Anemia of prematurity">Anemia of prematurity</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_disease" title="Gastrointestinal disease">Gastrointestinal</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ileus" title="Ileus">Ileus</a></li> <li><a href="/wiki/Necrotizing_enterocolitis" title="Necrotizing enterocolitis">Necrotizing enterocolitis</a></li> <li><a href="/wiki/Meconium_peritonitis" title="Meconium peritonitis">Meconium peritonitis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Integumentary_system" title="Integumentary system">Integument</a> and<br /><a href="/wiki/Thermoregulation" title="Thermoregulation">thermoregulation</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Erythema_toxicum_neonatorum" title="Erythema toxicum neonatorum">Erythema toxicum</a></li> <li><a href="/wiki/Sclerema_neonatorum" title="Sclerema neonatorum">Sclerema neonatorum</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Nervous_system_disease" title="Nervous system disease">Nervous system</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Perinatal_asphyxia" title="Perinatal asphyxia">Perinatal asphyxia</a></li> <li><a href="/wiki/Periventricular_leukomalacia" title="Periventricular leukomalacia">Periventricular leukomalacia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Musculoskeletal_disorder" title="Musculoskeletal disorder">Musculoskeletal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gray_baby_syndrome" title="Gray baby syndrome">Gray baby syndrome</a></li> <li><i><a href="/wiki/Muscle_tone" title="Muscle tone">muscle tone</a></i> <ul><li><a href="/wiki/Hypertonia" title="Hypertonia">Congenital hypertonia</a></li> <li><a href="/wiki/Hypotonia" title="Hypotonia">Congenital hypotonia</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Infections</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Vertically_transmitted_infection" title="Vertically transmitted infection">Vertically transmitted infection</a></li> <li><a class="mw-selflink selflink">Neonatal infection</a> <ul><li><a href="/wiki/Congenital_rubella_syndrome" title="Congenital rubella syndrome">rubella</a></li> <li><a href="/wiki/Neonatal_herpes_simplex" class="mw-redirect" title="Neonatal herpes simplex">herpes simplex</a></li> <li><a href="/wiki/Mycoplasma_hominis_infection" title="Mycoplasma hominis infection">mycoplasma hominis</a></li> <li><a href="/wiki/Ureaplasma_urealyticum_infection" class="mw-redirect" title="Ureaplasma urealyticum infection">ureaplasma urealyticum</a></li></ul></li> <li><a href="/wiki/Omphalitis" class="mw-redirect" title="Omphalitis">Omphalitis</a></li> <li><a href="/wiki/Neonatal_sepsis" title="Neonatal sepsis">Neonatal sepsis</a> <ul><li><a href="/wiki/Group_B_streptococcal_infection" title="Group B streptococcal infection">Group B streptococcal infection</a></li></ul></li> <li><a href="/wiki/Neonatal_conjunctivitis" title="Neonatal conjunctivitis">Neonatal conjunctivitis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Miscarriage" title="Miscarriage">Miscarriage</a></li> <li><a href="/wiki/Perinatal_mortality" title="Perinatal mortality">Perinatal mortality</a> <ul><li><a href="/wiki/Stillbirth" title="Stillbirth">Stillbirth</a></li> <li><a href="/wiki/Infant_mortality" title="Infant mortality">Infant mortality</a></li></ul></li> <li><a href="/wiki/Neonatal_withdrawal" title="Neonatal withdrawal">Neonatal withdrawal</a></li> <li><a href="/wiki/Fetal_Alcohol_Spectrum_Disorder" class="mw-redirect" title="Fetal Alcohol Spectrum Disorder">Fetal Alcohol Spectrum Disorder</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Vertically_transmitted_infections" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Vertically_transmitted_infection" title="Template:Vertically transmitted infection"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Vertically_transmitted_infection" title="Template talk:Vertically transmitted infection"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Vertically_transmitted_infection" title="Special:EditPage/Template:Vertically transmitted infection"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Vertically_transmitted_infections" style="font-size:114%;margin:0 4em"><a href="/wiki/Vertically_transmitted_infection" title="Vertically transmitted infection">Vertically transmitted infections</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Gestational</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>Viruses <ul><li><a href="/wiki/Congenital_rubella_syndrome" title="Congenital rubella syndrome">Congenital rubella syndrome</a></li> <li><a href="/wiki/Congenital_cytomegalovirus_infection" title="Congenital cytomegalovirus infection">Congenital cytomegalovirus infection</a></li> <li><a href="/wiki/Neonatal_herpes_simplex" class="mw-redirect" title="Neonatal herpes simplex">Neonatal herpes simplex</a></li> <li><a href="/wiki/Hepatitis_B" title="Hepatitis B">Hepatitis B</a></li> <li><a href="/wiki/Chickenpox#Infection_in_pregnancy_and_neonates" title="Chickenpox">Congenital varicella syndrome</a></li> <li><a href="/wiki/HIV" title="HIV">HIV</a></li> <li><a href="/wiki/Fifth_disease" title="Fifth disease">Fifth disease</a></li></ul></li> <li>Bacteria <ul><li><a href="/wiki/Congenital_syphilis" title="Congenital syphilis">Congenital syphilis</a></li></ul></li> <li>Other <ul><li><a href="/wiki/Toxoplasmosis" title="Toxoplasmosis">Toxoplasmosis</a></li></ul></li> <li><a href="/wiki/Perinatal_infection#Transplacental" class="mw-redirect" title="Perinatal infection">transplacental</a></li> <li><a href="/wiki/TORCH_complex" class="mw-redirect" title="TORCH complex">TORCH complex</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">During birth</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Perinatal_infection#Transcervical" class="mw-redirect" title="Perinatal infection">transcervical</a></li> <li><a href="/wiki/Candidiasis" title="Candidiasis">Candidiasis</a></li> <li><a href="/wiki/Gonorrhea" title="Gonorrhea">Gonorrhea</a></li> <li><a href="/wiki/Listeriosis" title="Listeriosis">Listeriosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Late pregnancy</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Listeriosis" title="Listeriosis">Listeriosis</a></li> <li><a href="/wiki/Congenital_cytomegalovirus_infection" title="Congenital cytomegalovirus infection">Congenital cytomegalovirus infection</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">By <a href="/wiki/Breastfeeding" title="Breastfeeding">breastfeeding</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Breastfeeding_difficulties#Health_of_the_infant" title="Breastfeeding difficulties">Breastfeeding</a></li> <li><a href="/wiki/Tuberculosis" title="Tuberculosis">Tuberculosis</a></li> <li><a href="/wiki/HIV" title="HIV">HIV</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q9386039" class="extiw" title="d:Q9386039">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/P36">P36</a> <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/A50">A50</a> <a 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