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Congenital cytomegalovirus (CMV) infection is the most common non-genetic cause of hearing loss and neurological disorder in children. Its overall prevalence is approximately 0.5% in Europe. In France, systematic screening during pregnancy is not recommended; screening is performed only if there are maternal or fetal symptoms suggestive of this infection. Approximately 90% of infected newborns are asymptomatic at birth, and among them the risk of neurosensory sequelae is 5–15%. By contrast, the prevalence of neurosensory impairment in symptomatic newborns at birth varies from 17% to 60%. Congenital CMV infection must be confirmed at birth before the 21st day of life by polymerase chain reaction (PCR) on saliva or urine samples. A complete clinical examination, blood tests (blood count, liver function test, CMV PCR), hearing tests, brain ultrasound and eye fundus examination should be performed. Neurological and auditory follow-up must be extended well beyond the neonatal period because the occurrence of neurosensory sequelae may be delayed. Oral valganciclovir is the recommended treatment in moderate or severe congenital CMV infections for a period of 6 weeks to 6 months; such treatment requires regular monitoring because of its possible side effects. [ABSTRACT FROM AUTHOR]

Résumé Le lait maternel est unique sur le plan biologique et nutritionnel. Sa composition évolue constamment pour répondre au mieux aux besoins de l’enfant jusqu’à 6 mois. La culture du biberon est en train de laisser progressivement place à celle de l’allaitement maternel comme en témoignent les dernières données épidémiologiques françaises. Si le taux d’initiation de l’allaitement maternel (AM) atteint en effet 76 à 86 % selon les régions, seuls 22 % des nourrissons restent allaités exclusivement à 6 mois. Dans les sociétés industrialisées, les jeunes mamans ont rarement vu d’autres mamans allaiter avant de le faire elles-mêmes. Avec les sorties précoces de maternité, beaucoup de femmes se trouvent désemparées face à d’inévitables petites difficultés. Les centres ressources (protection maternelle et infantile [PMI], pédiatres, généralistes, consultantes en lactation, association de soutien, etc.) vont alors avoir un rôle à part entière mais ne doivent pas diffuser des conseils inappropriés et/ou contradictoires. Combien d’interruptions d’allaitement pour une poussée de fièvre, une prescription médicamenteuse, un mamelon douloureux ou pire un renoncement à l’AM après une naissance prématurée ? C’est en se rapprochant au mieux des dernières connaissances sur la physiologie de la lactation qu’un allaitement maternel a le plus de chance de bien démarrer et de se prolonger sans douleur. [ABSTRACT FROM AUTHOR]

Supportive care comprises all care required by patients throughout the course of their disease, in combination with specific cancer and hematological treatments. Supportive care is an integral part of continuity of care designed to improve the patient’s quality of life during treatment. It also helps to maintaining the patient’s social and family integration. Supportive care comprises care associated with specific treatments which improve their safety (such as antiemetics or hematopoietic growth factors), with treatments designed to prevent or treat the consequences of the disease or chemotherapy (such as under nutrition, pain or febrile aplasia), or with care designed to improve patient’s comfort, palliative care, and psychological support for the child and his/her family. This article reviews these various problems and suggests daily practice guidelines for these various situations. [ABSTRACT FROM AUTHOR]

Objective: To define the predictive value (PV) of known prognostic factors of fetal infection with Cytomegalovirus following maternal primary infection <14 weeks of gestation, at different time points of pregnancy: the end of the second trimester; following prenatal magnetic resonance imaging (MRI) at 32 weeks of gestation; and using all ultrasound scans performed in the third trimester (US3rdT).Design: A retrospective study.Setting: Reference fetal medicine unit.Population: Sixty-two fetuses infected <14 weeks of gestation.Methods: We defined second-trimester assessment (STA) as the combination of ultrasound findings <28 weeks of gestation and fetal platelet count at cordocentesis. Three groups were defined: normal, extracerebral, and cerebral STA.Main Outcome Measures: For each group, the PV of STA alone, STA + MRI, and STA + US3rdT were assessed retrospectively. Outcome at birth and at follow-up were reported.Results: The STA was normal, and with extracerebral and cerebral features, in 43.5, 42.0, and 14.5%, respectively. The negative PV of normal STA and MRI for moderate to severe sequelae was 100%. The residual risk was unilateral hearing loss in 16.7% of cases. Of pregnancies with cerebral STA, 44% were terminated. Following extracerebral STA, 48% of neonates were symptomatic and 30% had moderate to severe sequelae. In those cases, the positive and negative PV of MRI for sequelae were 33 and 73%, respectively. STA + US3rdT had a lower negative PV than MRI for symptoms at birth and for moderate to severe sequelae. Any false-positive findings at MRI were mostly the result of hypersignals of white matter.Conclusions: Serial assessment in the second and third trimesters by ultrasound and MRI is necessary to predict the risk of sequelae occurring in 35% of pregnancies following fetal infection in the first trimester of pregnancy.Tweetable Abstract: Serial ultrasound prognostic assessment following fetal CMV infection in the 1st trimester is improved by MRI at 32 weeks. [ABSTRACT FROM AUTHOR]

Three cases of Bacillus cereus infection or colonization occurred in the same region in France, and milk from the milk bank was suspected as a possible common source of contamination. All Batches delivered to the three cases complied with the requirements of the bacteriological reference method recommended by good practices guidelines. Still, a retrospective analysis with a more sensitive method showed one batch to contain B. cereus, however straincomparison revealed no epidemiological link betweenisolates from patients and those from the milk. Consequently, in accordance with the precautionary principle, we developed a new sensitive method for the screening of pasteurized milk for pathogenic bacteria. From January 1 to August 31, 2017, 2526 samples of pasteurized milk were prospectively included in the study. We showed that a 20 mL sample of pasteurized milk incubated for 18 h at 37 °C under aerobic conditions was favoring the detection of B. Cereus. The nonconformity rate was 6.3% for the reference method and 12.6% for the improved method (p < 0.0001). Nonconformity was due to the presence of B. cereus in 88.5% of cases for the improved method and 53% of cases for the reference method (p < 0.0001). Thus our new method is improves the microbiological safety of the product distributed and only moderately increases the rate of bacteriological nonconformity . [ABSTRACT FROM AUTHOR]

To evaluate the outcome of infected fetuses following maternal primary infection with cytomegalovirus <14 weeks undergoing sequential ultrasound in the 2 SP nd sp and 3 SP rd sp trimesters and prenatal MRI. Second trimester prognostic assessment (STA) was the combination of ultrasound examination and fetal platelet count < 28 weeks. [Extracted from the article]

OC27.01: Neonatal outcome and long-term sequelae in CMV infected neonates according to the timing of primary maternal infection To relate time of maternal primary infection (PI) and outcome of congenitally infected off-springs. Abnormal neurodevelopment without HL in 6/143 (4%) followed PI in T1, T2, T3 in 3, 2, 1 cases respectively. [Extracted from the article]

An abstract of the research paper "Prenatal MRI Hypersignal Intensity of the White Matter in T2 Weight Sequences in Cytomegalovirus Infection: Myth or Reality," by B. Deloison and colleagues is presented.