"Clinical Features, Diagnosis, and Treatment of Congenital and Neonatal Tuberculosis: A Retrospective Study"

作者全名："Zhou, Yujiao; Zhu, Kun; Zhang, Xiayi; Zhu, Zheyi; Jiang, Li; Xing, Linlin; Xu, Binyue; Ai, Ting; Liu, Quanbo; Zhao, Ruiqiu; Xu, Ximing; Chen, Juan; Zhang, Zhenzhen"

作者地址："[Zhou, Yujiao; Zhang, Xiayi; Zhu, Zheyi; Jiang, Li; Ai, Ting; Liu, Quanbo; Zhao, Ruiqiu; Zhang, Zhenzhen] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Minist Educ,Childrens Hosp,Dept Infect Dis, Key Lab Child Dev & Disorders,Chongqing Key Lab C, Chongqing, Peoples R China; [Zhu, Kun] Chongqing Med Univ, Childrens Hosp, Dept Radiol, Chongqing, Peoples R China; [Xing, Linlin] Yubei Matern & Child Healthcare Hosp, Dept Pediat, Chongqing, Peoples R China; [Xu, Binyue] Chongqing Municipal Ctr Dis Control & Prevent, Chongqing, Peoples R China; [Xu, Ximing] Chongqing Med Univ, Childrens Hosp, Big Data Ctr Childrens Med Care, Chongqing, Peoples R China; [Chen, Juan] Chongqing Med Univ, Key Lab Mol Biol Infect Dis Designated, Chinese Minist Educ, Chongqing, Peoples R China"

通信作者："Zhang, ZZ (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Minist Educ,Childrens Hosp,Dept Infect Dis, Key Lab Child Dev & Disorders,Chongqing Key Lab C, Chongqing, Peoples R China."

来源：NEONATOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001118136600001

JCR分区：Q1

影响因子：2.6

年份：2024

卷号：121

期号：1

开始页：81

结束页：88

文献类型：Article; Early Access

关键词：Clinical features; Neonates; Treatment; Tuberculosis

摘要："Introduction: Limited studies have explored the clinical features, treatment, and prognosis of neonatal tuberculosis (TB). Here, we attempted to delineate the clinical characteristics of neonatal TB, which may help clinicians further understand this disease. Methods: A retrospective analysis of neonates diagnosed with congenital and/or neonatal TB disease from January 2010 to December 2020 was performed. Information on the demographic and epidemiological features, clinical symptoms, laboratory and imaging examinations, therapeutic regimens, and outcomes was collected. Kaplan-Meier analysis was used to present the time to disease onset, time to diagnosis, etc. Results: Forty-eight cases of neonatal TB were classified into congenital (n = 33) and postnatal (n = 15). The median time to disease onset in postnatal group was significantly longer than that in congenital group. Positive results for gastric fluid acid-fast bacilli, TB culture, Xpert MTB/RIF, interferon-gamma release assay (IGRA), and tuberculin skin test were detected in 26/48 (54.2%), 14/34 (41.2%), 11/18 (61.1%), 19/29 (65.5%), and 8/24 (33.3%) patients, respectively. For lymphadenopathy, computed tomography (CT) scans showed a higher detection rate than did X-ray (80.0% vs. 0). Of the 48 infants, 44/48 (91.7%) received anti-TB therapy, and 33/44 (75%) were clinically improved or cured after 22.1 months (interquartile range: 12.4-27.7) of follow-up. Drug-induced liver injury occurred in 14/44 (31.8%) patients. Discussion/Conclusion: IGRA and Xpert MTB/RIF showed good positive rate in neonatal TB infection/disease. In cases where TB is presumed but etiological evidence is lacking, low-dose CT could be considered. Prompt treatment under careful surveillance is important for preventing mortality and avoiding severe adverse effects."

基金机构：Chongqing Science and Technology Commission and Chongqing Health Commission [2020GDRC003]; Innovation and Entrepreneurship Plan for Overseas Returnees of Chongqing [CX2019103]; Chongqing Natural Science Foundation [cstc2021jcyj-msxmX0139]

基金资助正文："This work is funded by the joint medical research project of Chongqing Science and Technology Commission and Chongqing Health Commission (Grant No. 2020GDRC003, Zhang Z), the Innovation and Entrepreneurship Plan for Overseas Returnees of Chongqing (Grant No. CX2019103, Zhang Z), and the Chongqing Natural Science Foundation (Grant No. cstc2021jcyj-msxmX0139,Zhang Z)."