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新生儿梅毒:对感染母亲所生婴儿的临床及实验室评估与产后治疗

Neonatal syphilis: clinical and laboratory assessments and postnatal treatments for infants born to infected mothers.

作者信息

Atay Ünal Nursel, Savaş Şen Zeynep, Güneş Ömer, Tüfekçioğlu Eda, Yükkaldıran Pınar, Kulalı Ferit, Öz Fatma Nur, Aydın Teke Türkan, Kaman Ayşe

机构信息

Department of Pediatric Infectious Diseases, Etlik City Hospital, Ankara, Türkiye.

Department of Neonatology, Etlik City Hospital, Ankara, Türkiye.

出版信息

Eur J Clin Microbiol Infect Dis. 2025 May;44(5):1099-1105. doi: 10.1007/s10096-025-05073-0. Epub 2025 Feb 19.

Abstract

PURPOSE

This study aims to assess congenital syphilis incidence, main clinical presentations and the relation to maternal treatment during pregnancy, with the goal of raising awareness of this emerging public health issue and offering local epidemiological data.

METHODS

Infants born to mothers diagnosed with syphilis at Etlik City Hospital between June 1, 2023 and June 1, 2024 were included to the study. Patient records were reviewed retrospectively.

RESULTS

During the study period, 12,892 live births were recorded, with congenital syphilis detected in 0.12% of cases, corresponding to a rate of 116 cases per 100,000 live births. Fifteen neonates born to mothers with syphilis were evaluated. Penicillin treatment was administered to 93.3% of the neonates, including 73.3% classified as highly probable or probable cases. Bone abnormalities such as periostitis and osteitis were detected in two patients. Only 46.7% of mothers received adequate prenatal treatment, and 40% lacked prenatal care altogether. Co-infections with hepatitis C virus, human papillomavirus, and herpes simplex virus type 2 were noted in 26% of mothers, though none had HIV. Substance addiction was reported in 26.7% of mothers.

CONCLUSION

This study highlights a significant burden of congenital syphilis, with many cases stemming from untreated or inadequately managed maternal infections. Some neonates were infected despite maternal treatment, underscoring gaps in prevention. The limited data from our center, despite high case rates, likely underestimates the regional burden and risks missed diagnoses. These findings emphasize the urgent need for enhanced prenatal screening, timely treatment, and comprehensive care to mitigate congenital syphilis rates.

摘要

目的

本研究旨在评估先天性梅毒的发病率、主要临床表现及其与孕期母亲治疗的关系,以提高对这一新兴公共卫生问题的认识并提供当地的流行病学数据。

方法

纳入2023年6月1日至2024年6月1日在埃特利克市医院被诊断为梅毒的母亲所分娩的婴儿。对患者记录进行回顾性审查。

结果

在研究期间,共记录了12892例活产,其中先天性梅毒的检出率为0.12%,即每10万例活产中有116例。对15名梅毒母亲所生的新生儿进行了评估。93.3%的新生儿接受了青霉素治疗,其中73.3%被归类为高度可能或可能病例。两名患者检测到骨异常,如骨膜炎和骨炎。只有46.7%的母亲接受了充分的产前治疗,40%的母亲完全没有接受产前护理。26%的母亲同时感染了丙型肝炎病毒、人乳头瘤病毒和2型单纯疱疹病毒,不过均未感染艾滋病毒。26.7%的母亲有药物成瘾问题。

结论

本研究突出了先天性梅毒的重大负担,许多病例源于未治疗或管理不当的母亲感染。尽管母亲接受了治疗,但仍有一些新生儿被感染,这凸显了预防方面的差距。我们中心的数据有限,尽管病例率很高,但可能低估了区域负担,存在漏诊风险。这些发现强调迫切需要加强产前筛查、及时治疗和全面护理,以降低先天性梅毒的发病率。

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