congenital syphilis

先天性梅毒
  • 文章类型: Journal Article
    近年来,成人梅毒的发病率一直在上升,导致出生时患有先天性梅毒的新生儿数量增加。包括疾病控制和预防中心以及美国预防服务工作组在内的国家组织建议对孕妇进行常规检查,以在分娩前识别并提供孕产妇梅毒治疗。这些筛查的州之间存在显著的差异,导致一些孕妇在分娩前没有被诊断出来。儿科药学协会(PPA)认为,药剂师,与其他医疗保健提供者一起,可以通过确保孕妇和新生儿的最佳梅毒测试和治疗途径包括在他们的工作场所中来提供帮助。PPA还支持药剂师通过提供关于梅毒感染的最佳治疗的药物教育和咨询来提高治疗依从性。以及与州和地方政府合作,规范治疗建议。
    In recent years, rates of syphilis in adults have been on the rise resulting in an increase in the number of neonates born with congenital syphilis. National organizations including the Centers for Disease Control and Prevention as well as The US Preventative Services Task Force recommend routine testing of pregnant persons to identify and provide maternal syphilis treatment prior to delivery. Significant variability exists between states for these screenings, resulting in some pregnant persons not being diagnosed prior to delivery. The Pediatric Pharmacy Association (PPA) believes that pharmacists, along with other health care providers can help by ensuring optimal syphilis testing and treatment pathways for pregnant individuals and newborns are included in their workplaces. PPA also supports pharmacists working to increase treatment compliance by providing medication education and counseling regarding optimal treatment of syphilis infections, as well as work with state and local governments to standardize treatment recommendations.
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  • 文章类型: Journal Article
    背景技术先天性梅毒(CS)被认为是发展中国家可预防死亡的第二大原因。上次报告CS的发病率是在2017年。目的本研究的目的是估计2019-2023年间CS的发病率。材料和方法这是一项回顾性研究,其数据来自2019-2023年《流行病学公报》中报告的CS新病例以及国家统计与地理研究所和国家人口委员会报告的新生儿记录。结果在墨西哥,CS的发病率为每10,000例新生儿中3.20例。在2019年至2023年之间观察到CS病例的增加,2022年的病例数量更高。结论需要民主化的检测和及时的管理来减少传播,特别是在最脆弱的人群中。
    Introduction Congenital Syphilis (CS) is considered the second leading cause of preventable death in developing countries. The last report of the incidence rate of CS was made in 2017. Objective The objective of the study was to estimate the incidence of CS between 2019-2023. Materials and methods This is a retrospective study for which data were obtained from the new cases of CS reported in the Epidemiological Bulletin for 2019-2023 and from the newborn population records reported in the National Institute of Statistics and Geography and the National Population Council. Results In Mexico, the incidence rate of CS is 3.20 per 10,000 births. An increment of CS cases was observed between 2019-2023, with a higher number of cases in 2022. Conclusion A democratization of detection and prompt management is needed to reduce transmission, particularly among the most vulnerable population.
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  • 文章类型: Letter
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  • 文章类型: Case Reports
    先天性梅毒(CS)是由梅毒螺旋体引起的垂直传播感染。由于适当的产前筛查,很少见。体征和症状出现在早期CS的生命的前2年和晚期CS的2年后。早期不能诊断和治疗CS会导致更高的发病率和死亡率。皮肤表现可以指导早期CS的诊断。这里,我们报告了一名2天大的新生儿,他出现了肢端皮肤脱落,并伴有呼吸窘迫和肝脾肿大。对CS进行了临床怀疑,随后在母亲和儿童中进行了阳性性病研究实验室检查。根据CDC指南,该儿童接受了水性结晶青霉素G治疗。
    Congenital syphilis (CS) is a vertically transmitted infection caused by the spirochete Treponema pallidum. It is seen rarely due to proper antenatal screening. Signs and symptoms appear within the first 2 years of life in early CS and after 2 years in late CS. Failure to diagnose and treat CS in its early stages can result in higher morbidity and mortality. Skin manifestations can guide toward the diagnosis of CS at an early stage. Here, we report a 2-day-old neonate who presented with acral peeling of skin along with respiratory distress and hepatosplenomegaly. Clinical suspicion of CS was made and subsequently confirmed by a positive venereal disease research laboratory test in both mother and child. The child was treated with aqueous crystalline penicillin G as per the CDC guidelines.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    自2000年代以来,美国和国际上的梅毒和先天性梅毒(CS)病例一直在上升。社会因素已被证明会增加CS传播的风险。COVID-19大流行可能导致梅毒传播增加。我们旨在量化大型城市医院先天性梅毒(CS)发病率的上升以及COVID-19大流行对CS发病率的影响。我们在2016年1月1日至2022年6月1日期间在城市学术医院完成了61例梅毒检测阳性或既往诊断为梅毒的孕妇的回顾性图表回顾。孕产妇梅毒和CS率在5年内增加(p<0.001),特别是COVID-19前后(p<0.001)。在研究过的母亲中,34.6%接受了足够的产前护理,62.7%接受了充分的筛查,81.3%接受了适当的治疗。在6.6%的怀孕中发现了死胎。活出生的婴儿,97.6%接受了适当的治疗,45.1%接受了充分的随访。CS的发展与无家可归(p=0.028)和过去的阿片类药物使用(p=0.031)显着相关。我们得出的结论是,我们医院的孕产妇梅毒和CS率有所增加,特别是在COVID-19大流行期间。获得产前护理和及时产妇治疗是需要改进的目标领域。
    Syphilis and congenital syphilis (CS) cases have been rising in the U.S. and internationally since the 2000s. Social factors have been shown to increase the risk of CS transmission. The COVID-19 pandemic may have contributed to increased syphilis transmission. We aimed to quantify the rise in congenital syphilis (CS) rates at a large urban hospital and the impact of the COVID-19 pandemic on CS rates. We completed a retrospective chart review of 61 pregnant women with a positive test or previous diagnosis of syphilis at an urban academic hospital between 1 January 2016 and 1 June 2022. Maternal syphilis and CS rates increased over the 5 years (p < 0.001), particularly pre- and post-COVID-19 (p < 0.001). Of the mothers studied, 34.6% received adequate prenatal care, 62.7% received adequate screening, and 81.3% received adequate treatment. Stillbirth was noted in 6.6% of pregnancies. Of liveborn infants, 97.6% received appropriate treatment, and 45.1% received adequate follow-up. CS development was significantly associated with homelessness (p = 0.028) and past opioid use (p = 0.031). We concluded that maternal syphilis and CS rates have increased at our hospital, particularly during the COVID-19 pandemic. Access to prenatal care and timely maternal treatment are target areas for improvement.
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  • 文章类型: Journal Article
    先天性梅毒带来了巨大的全球负担,导致胎儿丢失,死产,新生儿死亡率,和先天性感染。尽管世界卫生组织(世卫组织)在2007年确定了每10万活产不到50例的目标,全球发病率正在上升,特别是在中低收入地区。最近的数据表明,每10万活产婴儿中有473例病例,导致661,000例先天性梅毒,包括355,000个不良出生结局,例如早期胎儿死亡,死产,新生儿死亡,早产或低出生体重婴儿,和临床先天性梅毒的婴儿。令人震惊的是,这些不良结局中只有6%发生在登记的母亲身上,筛选,和治疗。与许多新生儿感染不同,通过有效的产前筛查和感染孕妇的治疗,先天性梅毒是可以预防的。然而,尽管有可用的筛查工具,负担得起的治疗选择,以及将预防计划纳入各国的产前保健,先天性梅毒仍然是全球紧迫的公共卫生问题。这篇综述旨在总结当前的流行病学,传输,和治疗妊娠梅毒,以及探索减少垂直传播的全球努力,并解决未能达到世卫组织消除目标的原因。
    Congenital syphilis presents a significant global burden, contributing to fetal loss, stillbirth, neonatal mortality, and congenital infection. Despite the target established in 2007 by the World Health Organization (WHO) of fewer than 50 cases per 100,000 live births, the global incidence is on the rise, particularly in low- and middle-income regions. Recent data indicate a rate of 473 cases per 100,000 live births, resulting in 661,000 total cases of congenital syphilis, including 355,000 adverse birth outcomes such as early fetal deaths, stillbirths, neonatal deaths, preterm or low-birth-weight births, and infants with clinical congenital syphilis. Alarmingly, only 6% of these adverse outcomes occurred in mothers who were enrolled, screened, and treated. Unlike many neonatal infections, congenital syphilis is preventable through effective antenatal screening and treatment of infected pregnant women. However, despite available screening tools, affordable treatment options, and the integration of prevention programs into antenatal care in various countries, congenital syphilis remains a pressing public health concern worldwide. This review aims to summarize the current epidemiology, transmission, and treatment of syphilis in pregnancy, as well as to explore global efforts to reduce vertical transmission and address the reasons for falling short of the WHO elimination target.
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  • 文章类型: Journal Article
    梅毒,一种普遍的性传播感染,构成严重风险,尤其是在怀孕期间。本研究旨在阐明广西梅毒流行趋势和影响,中国,专注于患病率,临床表现,以及孕妇和新生儿的治疗结果。目标包括了解受影响孕妇的人口特征,分析新生儿的临床表现,并评估治疗方案的有效性。
    遵守道德准则,2013年1月至2023年12月的一项回顾性队列研究纳入了54,048名接受梅毒螺旋体检测的孕妇.诊断涉及全面的方法,利用测试如甲苯胺红不加热血清测试(TRUST)和梅毒螺旋体颗粒凝集(TPPA)测定。通过长达十年的随访评估了婴儿的诊断和临床表现。治疗方案,包括苄星青霉素,已实施。使用SAS版本9.4进行统计分析。
    在54,048名孕妇中,0.10%为梅毒阳性,与住院率上升有关。新生儿表现出不同的临床表现,新生儿肺炎和黄疸很普遍。治疗方案,尤其是苄星青霉素,取得了显著的100%治愈成功率。该研究指出,母婴传播显着减少。母亲和婴儿的梅毒在不同的临床阶段被诊断出来,包括主要的,次要,潜在的,和第三。
    这项研究强调了梅毒对广西孕妇和新生儿的影响,中国。调查结果强调了采取强有力的预防措施的必要性,早期诊断,和有效的治疗策略。观察到的100%使用苄星青霉素的治愈成功率强调了严格治疗方案在减轻先天性梅毒的不良反应和减少其传播方面的重要性。
    UNASSIGNED: Syphilis, a prevalent sexually transmitted infection, poses severe risks, especially during pregnancy. This study aimed to elucidate the trends and impacts of syphilis in Guangxi, China, focusing on prevalence, clinical manifestations, and treatment outcomes in pregnant women and newborns. The objectives included understanding the demographic characteristics of affected pregnant women, analysing the clinical manifestations in newborns, and assessing the effectiveness of the treatment protocol.
    UNASSIGNED: Conducted in adherence to ethical guidelines, a retrospective cohort study from January 2013 to December 2023 included 54,048 pregnant women tested for T. pallidum. Diagnosis involved a comprehensive approach, utilizing tests like the Toluidine Red Unheated Serum Test (TRUST) and the Treponema pallidum Particle Agglutination (TPPA) assay. Infant diagnosis and clinical manifestations were evaluated through a decade-long follow-up. Treatment protocols, including Benzathine penicillin, were implemented. Statistical analyses were conducted using SAS version 9.4.
    UNASSIGNED: Among 54,048 pregnant women, 0.10% were syphilis positive, correlating with a rise in hospitalizations. Newborns exhibited varied clinical manifestations, with neonatal pneumonia and jaundice being prevalent. The treatment protocol, especially with Benzathine penicillin, achieved a remarkable 100% cure success rate. The study noted a significant reduction in mother-to-child transmission. Syphilis in mothers and babies was diagnosed at different clinical stages, including primary, secondary, latent, and tertiary.
    UNASSIGNED: This study underscores the escalating impact of syphilis on pregnant women and newborns in Guangxi, China. The findings highlight the necessity for robust preventive measures, early diagnosis, and effective treatment strategies. The observed 100% cure success rate with Benzathine penicillin emphasizes the importance of strict treatment protocols in mitigating the adverse effects of congenital syphilis and reducing its transmission.
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  • 文章类型: Journal Article
    这项研究的目的是分析圣保罗市高流行地区先天性梅毒(CS)的时空风险,SP,巴西,并评估其与社会经济的关系,人口统计学,和环境变量。根据2010年至2016年从310个地区收集的具有时空成分的次级CS数据进行了生态研究。使用集成嵌套拉普拉斯近似(INLA)方法在贝叶斯背景下对数据进行建模。风险图显示,随着时间的推移,CS趋势不断增加,并突出显示了每年风险最高和最低的领域。该模型显示,与CS风险较高正相关的因素是Gini指数和18-24岁未受过教育或初等教育不完整的女性比例,而与育龄妇女比例和人均收入呈负相关的因素。
    The aim of this study is to analyze the spatiotemporal risk of congenital syphilis (CS) in high-prevalence areas in the city of São Paulo, SP, Brazil, and to evaluate its relationship with socioeconomic, demographic, and environmental variables. An ecological study was conducted based on secondary CS data with spatiotemporal components collected from 310 areas between 2010 and 2016. The data were modeled in a Bayesian context using the integrated nested Laplace approximation (INLA) method. Risk maps showed an increasing CS trend over time and highlighted the areas that presented the highest and lowest risk in each year. The model showed that the factors positively associated with a higher risk of CS were the Gini index and the proportion of women aged 18-24 years without education or with incomplete primary education, while the factors negatively associated were the proportion of women of childbearing age and the mean per capita income.
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  • 文章类型: Journal Article
    近年来,东京的梅毒病例数量有所增加。我们进行了描述性流行病学来阐明梅毒的实际状况。年龄数据,性别,疾病阶段,并对东京报告的梅毒病例的假定性伴侣进行了列表和分析。在2019年至2022年期间,共报告了9,419例梅毒病例。从2021年到2022年,报告的病例数量急剧上升。比较2020年至2022年,20多岁女性的梅毒病例数量,迅速增加,超过三倍。此外,2022年梅毒病例中的孕妇人数增加.尽管患有梅毒的年轻女性人数迅速增加,先天性梅毒病例没有增加。原因之一可能是由于东京的产前检查率高,在怀孕早期发现了梅毒。然而,年轻女性梅毒的持续发病率将来可能会增加先天性梅毒。公共卫生战略应包括针对高危人群或青少年的教育活动,早期和适当的测试,以及预防梅毒进展的治疗。
    The number of syphilis cases in Tokyo has been found to increase in recent years. We conducted a descriptive epidemiology to elucidate the actual status of syphilis. Data on age, sex, disease stage, and presumed sexual partner of syphilis cases reported in Tokyo were tabulated and analyzed. A total of 9,419 syphilis cases have been reported between 2019 and 2022. There was a particularly sharp rise in the number of reported cases from 2021 to 2022. Comparing 2020 to 2022, the number of syphilis cases among women in their 20s, rapidly increased, more than triple. Furthermore, the number of pregnant women among syphilis cases increased in 2022. Despite the rapid increase in the number of young women with syphilis, there has been no increase in cases of congenital syphilis. One of the reasons may be that syphilis was detected early in pregnancy due to the high antenatal checkup rate in Tokyo. However, the continued incidence of syphilis among young women may increase congenital syphilis in the future. Public health strategy should include educational activities targeting high-risk populations or adolescents, early and appropriate testing, and treatment for preventing progression of syphilis.
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