Department of Pediatrics, St. John's National Academy of Health Sciences, Bangalore, 560034, India.
Indian J Pediatr. 2011 Jan;78(1):88-95. doi: 10.1007/s12098-010-0254-3. Epub 2010 Oct 16.
Infections acquired in utero or in the immediate post-natal period play a prominent role in perinatal and childhood morbidity. The TORCH constellation continues to be popular among perinatologists and paediatricians, although its limitations are increasingly known. A host of new organisms are now considered to be perpetrators of congenital and perinatal infections, and a diverse range of diagnostic tests are now available for confirming infection in the infant. In general, the collective TORCH serological panel has low diagnostic yield; instead individual tests ordered according to clinical presentation can contribute better towards appropriate diagnosis. This review captures the essence of established congenital infections such as cytomegalovirus, rubella, toxoplasmosis, syphilis and herpes simplex virus, as well as more recent entrants such as HIV and hepatitis B infection, varicella and tuberculosis. Selective screening of the mother and newborn, encouraging good personal hygiene and universal immunization are some measures that can contribute towards decreasing the incidence and morbidity of congenital and perinatal infections.
在围产期和儿童时期发病的感染中，宫内或出生后即刻获得的感染起着重要作用。虽然围生期医学家和儿科医生越来越了解 TORCH 综合征的局限性，但它仍然很流行。现在，许多新的病原体被认为是先天性和围生期感染的病原体，并且现在有多种诊断检测方法可用于确认婴儿的感染。一般来说，整个 TORCH 血清学检测的诊断效果较低；相反，根据临床表现订购的个别检测可以更好地有助于进行适当的诊断。本综述涵盖了巨细胞病毒、风疹、弓形体病、梅毒和单纯疱疹病毒等已确立的先天性感染，以及艾滋病毒和乙型肝炎感染、水痘和结核病等较新的感染。对母亲和新生儿进行选择性筛查、鼓励良好的个人卫生和普遍免疫接种是有助于降低先天性和围生期感染发病率和发病率的一些措施。
