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Arch Pediatr. 2012 Apr;19(4):396-403. doi: 10.1016/j.arcped.2012.01.017. Epub 2012 Feb 28.

[Neonatal exposure to active pulmonary tuberculosis in a maternity ward: screening and clinical course of a cohort of exposed infants].

[Article in French]

Author information

  • 1Service de pédiatrie générale, hôpital Robert-Debré, Assistance Publique des hôpitaux de Paris, 48 boulevard Sérurier, Paris, France.

Abstract

Few data are available on the impact of a tuberculosis exposure on newborns in a maternity ward.

OBJECTIVES:

To describe the screening and clinical course of infants exposed during the neonatal period to a caregiver with bacillary tuberculosis.

PATIENTS AND METHODS:

Infants exposed during the postnatal period in a maternity unit in Paris, from March to August 2005, to a caregiver with bacillary tuberculosis were included in a standardized screening protocol. The screening performed at baseline (M0) and at 3 months (M3) included a clinical evaluation, a tuberculin skin test (TST), and a chest X-ray. A preventive treatment for tuberculosis with isoniazid and rifampicin for 3 months was systematically proposed.

RESULTS:

At M0, 182 of the 217 infants (84%) with significant exposure were evaluated. Data were available for 172 infants. The median age at M0 was 4.9 months (IQR=3.8-6.2). At M0, 4 of 172 infants (2.3%) had latent TB infection. Between M0 and M3, 19 infants (11%) were lost to follow-up and 1 on 153 developed a latent TB infection. No cases of tuberculosis disease were diagnosed. The treatment was administered properly in 83% of cases and side effects were observed in 11% of infants without any serious adverse event. Four infants received no treatment and 11 stopped their treatment prematurely.

CONCLUSION:

In the absence of neonatal massive exposure, although low (2.9%), the risk of latent TB infection requires close monitoring of the infants exposed. However, in the context of a mild exposure in the maternity unit, surveillance without systematic initiation of TB preventive treatment could be discussed.

Copyright © 2012 Elsevier Masson SAS. All rights reserved.

PMID:
22377245
[PubMed - indexed for MEDLINE]
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