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L’infection néonatale secondaire à Salmonella typhimurium est rare et peut revêtir des aspects cliniques variables pouvant aller jusqu’au sepsis grave souvent mortel. L’objectif de ce travail est d’étudier les aspects cliniques, bactériologiques et évolutifs de l’infection néonatale à S. typhimurium productrice de bêtalactamases à spectre élargi (BLASE+), au moyen d’une étude rétrospective sur une durée de trois ans incluant cinq observations. Tous les cas étaient en provenance du même hôpital provincial. L’âge moyen était de 16 jours. La symptomatologie principale était liée à un tableau de déshydratation aiguë. Le bilan bactériologique a objectivé un S. typhimurium BLSE+ chez tous les cas. La prise en charge thérapeutique a reposé sur une antibiothérapie adaptée à l’antibiogramme, associée à un traitement symptomatique. L’évolution fut favorable dans quatre cas et fatale pour un seul patient en raison d’un sepsis extrêmement sévère. Bien que les céphalosporines de troisième génération soient le traitement de référence, l’émergence de souches de plus en plus résistantes rend indispensable l’adaptation de l’antibiothérapie à l’antibiogramme du germe isolé.

Objective: This study aimed to estimate the prevalence and identify the associated factors of breastfeeding (BF) practice in the NICU of Casablanca Ibn Rochd teaching hospital.Method: A cross-sectional study was performed between 04 January and 26 June 2021 in NICU. Moroccan couples' mother/newborn were consecutively recruited after meeting the study inclusion criteria. We used face-to-face interviews using a pretested questionnaire. Our income variable was the proportion of mothers who exclusively or partially breastfed at least one time after admission, categorized by yes and no. Multiple binary logistic regression was used to test the association of income variable with predictors. Findings: We included 170 couple mother/newborn. Around 74% of mothers practiced partial breastfeeding. The mother factors associated with BF practice were: education level (OR=0,10; 95%CI : 0,01-0,87; p=0,037781), family monthly income (OR=4,3 ; 95%CI: 1,12-16 ,56 ; p=0,033606) and marital status (OR=14,3 ; 95%CI:1,37-148,43 ; p=0,025853). The newborns' factors associated to BF practice were: hospital stay length (OR= 1,12 95%CI: 1,00-1,25 ; p=0,047726) and Hospitalization motif (OR=0,27 ; 95%CI: 0,076-0,95 ; p=0,042085). And healthcare facility factors associated to BF practice was: healthcare staff support: (OR=6,7 ; 95%CI:2,2-20,54 ; p=0,000891).Conclusion: The newborns hospitalized for respiratory distress from single mothers with lower education levels and social standards who did not have enough (or any) support from healthcare staff were the ones who received less breast milk in the NICU of Casablanca Ibn Rochd teaching hospital.

A male late preterm newborn was born by vaginal delivery at a gestational age of 34 weeks. At 3 hours of life, he was admitted for early moderate neonatal respiratory distress in the Neonatal Medicine and Resuscitation Service. Cerebrospinal fluid culture yieldedThis finding shows that clinical manifestations of neonatal pneumococcal meningitis may be atypical and/or misleading.

Background: In Morocco the breast feeding (exclusive) prevalence has decreased from 51% in 1992 to 35% in 2018. This prevalence was lower in neonatal intensive care unit (NICU) with 12.4% in 2014. The aim of this study was to estimate the prevalence and identify the associated factors of breastfeeding (BF) practice in NICU of Casablanca Ibn Rochd teaching hospital.Method:A cross sectional study was performed between 04 January and 26 June 2021 in NICU. We included Moroccan couples mother/newborn who can practice the BF presents during the study period. We used face to face interview using pretested questionnaire. Logistic regression was used to test association between breastfeeding (BF) practice and potential associated factors. Factors with p ≤ 0.05 were considered as associated factors of BF practice. Data were analyzed using R 3.6.3 Findings: We included 170 couple mother/newborn. Around 74% of mothers practiced partial breastfeeding. The mother factors associated with BF practice were: education level (OR=0,10; 95%CI : 0,01-0,87 ;p=0,037781), family monthly income (OR=4,3 ; 95%CI: 1,12-16 ,56 ; p=0,033606) and marital status (OR=14,3 ; 95%CI:1,37-148,43 ; p=0,025853). The newborns’ factors associated to BF practice were: hospital stay length (OR= 1,12 95%CI: 1,00-1,25 ; p=0,047726) and hospitalization motif (OR=0,27 ; 95%CI: 0,076-0,95 ; p=0,042085). And healthcare facility factors associated to BF practice was: healthcare staff support: (OR=6,7 ; 95%CI:2,2-20,54 ; p=0,000891) .Conclusion: The newborn hospitalized for respiratory distress from single mothers with lower education level and social standard who, don’t have enough (or any) support from healthcare staff are the ones who receive less breast milk in NICU of Casablanca Ibn Rochd teaching hospital.

Background Globally infectious diseases remain the leading causes of child hood mortality and morbidity accounting for 65% of all deaths in under-five children which can be prevented if proper sanitation and hygiene measure undertaken. The aim of this study is to determine the factors associated to hand hygiene of newborn mothers in NICU of Ibn Rochd teaching hospital in Casablanca (Morocco). Methods A cross-sectional study was performed from 04 January to 15 April 2021. We included Moroccan couple newborn/mother presents in NICU during the study period. We used face to face interview using close ended questionnaire. The number of time per day the mothers used soap or alcohol for hand hygiene(6 times per day) was used to measure the variable “hand hygiene practice” The Khi2 and Kruskal-wallis tests were used to test association between hand hygiene and potential associated factors. Associated factors with p ≤ 0.05 were considered as significantly associated factors of hand washing practice. Data were analyzed using R 3.6.3. Findings We included 89 couple mother/newborn. Forty five percent practice adequate hand hygiene (washing with soap or hand rub sanitizer) between 3 and 6 times per day. Factors significantly associated with hand hygiene were: mothers' residence (rural 33.7%; urban 66.3%; p = 0,026); prenatal visit number (visits number mean: < 3 times =3.67; 3-6 times = 3.30; > 6times = 5.08; p = 0,011). Conclusions The mothers from urban residence accessing more prenatal visits practice hand hygiene more frequently than single mothers from rural residence with limited access of prenatal visits. So this study suggests the training programs to enhance mothers hand hygiene practice should prioritize the mothers from rural residence who attended less prenatal visits. Key messages We can protect the fragile hospitalized newborn from infections by cheapest gestures like hand hygiene. Hand hygiene must be continually promoted targeting all actors involved about newborn care specifically newborn mothers.

Background Breastfeeding (BF) is one of the most effective ways to ensure child health and survival. In Morocco the BF rate decreased from 51% to 27,8% between 1992 and 2011. The breast feeding rate in neonatal intensive care unit (NICU) is lower 12,4%. Studies showed if we improve the mothers knowledge, the BF practice rate increase in NICU. We aim to determine associated factors of mothers knowledge about BF in NICU of Ibn Rochd teaching hospital in Casablanca (Morocco). Methods A cross-sectional study was conducted between 04 January and 23 April 2021 in NICU ward of teaching hospital Ibn Roch of Casablanca (Morocco). We included Moroccan mothers who can practice the BF presents during the study period. We used face to face interview using questionnaire. A scoring system from 0 to 16 points was used to measure the knowledge. The student, ANOVA, Mann-Whitney-Wilcoxon, Kruskal Wallis, Pearson and spearman correlation tests were used to test association between BF and potential associated factors. Associated factors with p ≤ 0.05 were considered as determinants of BF. Data were analyzed using R 3.6.3. Results We included 111 mothers. The mean score of knowledge was 10.38 ± 2.31. Associated factors with BF knowledge were: healthcare staffs support (yes mean score =11.06 and no = 9.72; p = 0.002); getting prior information about BF (yes mean score =10.53 and no = 9; p = 0.012). The knowledge increase with age of mother (correlation coefficient = 0.26; p = 0.005) and parity (correlation coefficient = 0.30; P = 0.001). Conclusions Mothers and specifically younger primiparous should receive more attention from training program and healthcare staffs in NICU to improve the knowledge and practice of BF. Key messages we can enhance significantly the survival and health of newborn hospitalized in NICU by simple actions as advices, encouragement toward the newborn mothers to improve their knowledge about BF. Healthcare staffs and facilities have to be the teachers and school about breast feeding.

Background Improving breast milk feeding (BF) can avoid globally per year 800000 deaths in children under 5 years old. In Morocco the breast milk feeding rate decreased from 51% to 27,8% between 1992 and 2011, the breast feeding rate in neonatal intensive care unit (NICU) is lower (12,4%). The objective of this study is to determine the associated factors of BF practice in NICU. Methods A cross-sectional study was conducted between 04 January and 20 April 2021 in NICU ward of teaching hospital Ibn Roch of Casablanca (Morocco). We included Moroccan couples mother/newborn who can practice the BF presents during the study period. We used face to face interview using questionnaire. Student, Mann-Whitney-Wilcoxon and Khi2 tests were used to test association between BMF and potential associated factors. The potential associated factors with p ≤ 0.05 were considered as associated factors of BF practice. Data were analyzed using R 3.6.3. Results We included 107 couple mother/newborn. Around 77% of mothers practice BF. The mother factors associated with BF practice were: residence (30.5% rural; 69.5% urban; p = 0.007); marital status (2.4% single; 0% divorced; 97.6% married; p = 0.02); getting prior information about BF (6.2% no; 93.8%yes; p = 0.02), mother knowledge score about BF (median score yes = 10, no = 9;p= 0.03). The newborn associated factors were: hospitalization reasons (50.7% respiratory distress; 17.3% infections; 13.3% jaundice; 18.7% others; p = 0.03) and the gender (58.2% male; 41.8% female; p = 0,02) Conclusions The practice rate is lower for rural single mother who don't get any prior information about BF (lower knowledge). These mothers must get more attention from the healthcare staffs and training programs to improve the breast feeding in NICU. Key messages We can do better about the management of newborn hospitalized in NICU with actions like BF practice (promotion of breastfeeding). The benefits of breast feeding practice are significantly greater than his risks about the management of newborn hopitalized in NICU.

Le syndrome de Kasabach-Merritt (SKM) est une affection rare et grave qui associe une lésion vasculaire (hémangiome), un syndrome hématologique dominé par une thrombopénie, souvent profonde, exposant à un syndrome hémorragique et une coagulopathie de consommation plus ou moins marquée ; le traitement est souvent difficile. Nous rapportons le cas d’un nouveau-né admis à j6 de vie pour un SKM compliquant un hémangiome cutané inopérable. Le traitement reposant initialement seulement sur la corticothérapie n’a amené aucune amélioration, puis l’association de la vincristine a permis une augmentation rapide du taux sanguin des plaquettes ainsi qu’une nette régression du volume de l’hémangiome. Par son action antimitotique inhibitrice de l’angiogenèse, la vincristine semble être un traitement efficace et bien toléré du SKM ; elle permet de contrôler la coagulopathie et d’éradiquer la tumeur vasculaire.

Introduction Coronavirus disease 2019 (COVID-19) has spread rapidly across the world. Given the sharply increased infection rate, the number of pregnant women and children with COVID-19 is correspondingly on the rise. SARS-CoV-2 infection is transmitted through droplets; though hypothesized, other transmission routes have not been confirmed. As of now, it remains unclear whether and how SARS-CoV-2 can possibly be transmitted from the mother to the fetus. Method This study examines the medical records of 30 neonates born to women with COVID-19, the objective being to provide documented information on maternal-child transmission and infant outcomes. Results Out of the 30 newborns, 28 had negative PCR test results for SARS-CoV-2; among their mothers, fifteen had fever, nine had cough and twenty had delivered by cesarean section. The median birth term was 37wk2dy, and twenty of the neonates were male. Most of them were asymptomatic, except for the three who presented with shortness of breath. Two of them were intubated and both died, the first because of severe sepsis and the second due to severe hyaline membrane disease. As regards the two infected neonates, the first represents a probable case of congenital SARS-CoV-2 infection, which appears unlikely in the second case. The outcome for both of them was good, without any complications. Conclusion Maternal-fetal transmission of the SARS- CoV-2 virus was not detected in the majority of the reported cases, although two of 30 neonates had positive qRT-PCR test results. Our study supports the hypothesis that though it seldom actually occurs, in utero SARS-CoV-2 vertical transmission is possible.

Resume L’hematome surrenalien est une affection rare en periode neonatale, le plus souvent d’origine traumatique. Nous en rapportons trois observations colligees sur une periode de deux ans (janvier 2011 a decembre 2012). L’âge moyen des enfants etait de cinq jours. Le mode de revelation etait varie, domine par un ictere intense dans un cas, une insuffisance surrenalienne aigue dans un cas et une anemie profonde dans un autre cas. L’echographie abdominale avait confirme le diagnostic et permis le suivi de l’hemorragie surrenalienne chez tous les enfants. L’evolution, appreciee sur les donnees cliniques, biologiques et radiologiques, a ete favorable chez tous les enfants. A travers ces observations, nous discutons les facteurs de risque, les modes de revelation, l’evolution et la prise en charge d’une hemorragie surrenalienne en periode neonatale.

Resume L’infection congenitale a Candida est une maladie rare, ne survenant que dans 10 a 35 % des grossesses. L’atteinte peut etre sous forme d’une candidose cutanee ou d’une forme systemique engageant le pronostic vital. Cet article rapporte un cas d’atteinte candidosique cutanee congenitale, et discute les caracteristiques cliniques et biologiques permettant de la differencier des autres dermatoses neonatales. Il s’agit d’un nouveau-ne a terme. L’anamnese infectieuse est positive. L’accouchement a eu lieu par cesarienne pour un etat fœtal non rassurant. A j2 de vie, le nouveau-ne presente des lesions maculopapuleuses generalisees evoluant vers des lesions vesiculopustuleuses ne respectant pas les paumes et les plantes, ainsi qu’un decollement cutane dans un contexte febrile. L’etude mycologique des lesions a reconforte la suspicion clinique de candidose cutanee, en isolant de nombreuses colonies de Candida albicans . La candidose cutanee congenitale (CCC) est une infection rare, toutefois son diagnostic et sa prise en charge doit etre precoce pour eviter la dissemination systemique d’evolution fatale.

Resume Les fistules bronchobiliaires congenitales (FBBC) sont des malformations rares. Nous en rapportons une observation chez un nouveau-ne de 6 j, revelee par une insuffisance respiratoire avec bilioptysie, prise initialement pour une inhalation de liquide amniotique. L’aggravation de l’insuffisance respiratoire a fait pratiquer une bronchoscopie qui confirmait le diagnostic. Le nouveau-ne a ete opere a l’âge de 26 j et est decede le lendemain. L’opacification peroperatoire montrait la communication entre la carene et les voies biliaires. Nous rappelons les caracteristiques cliniques des FBBC et l’interet d’un diagnostic et d’une cure chirurgicale precoces afin d’eviter les complications pulmonaires dues aux sels biliaires.

In september 2013, an outbreak of Serratiamarcescens infection occured in the neonatal intensive care unit of children’s hospital Abderrahim Harrouchi in Casablanca. Rapid microbiological investigation lead to identify nine cases of S. marcescens sepsis.The environemental investigation didn’t detect S.marcescens. Strict hygiene measures were lead to early interruption of the outbreak, without reccurences to this date still.

Gastric pneumatosis is a rare pathology. Its occurrence in the neonatal period requires looking for ulcerative-necrotizing enterocolitis in a context of prematurity or an underlying surgical obstacle. We report a case of gastric pneumatosis at a newborn child born at term, admitted on the third day of life for neonatal occlusion with a flat stomach. The abdomen without preparation showed substantial gastric distension with aspects of gastric pneumatosis and embellishes with images showing a double gastric bubble. The surgical exploration showed gastric pneumatosis, complete duodenal atresia located at the level of the second duodenal portion, and an annular pancreas. Progression was favorable after duodenostomy.

Neonatal tetanus (NT) remains common in developing countries. Its poor prognosis is characterized by a high mortality rate. Patients and methods – Our retrospective review concerned 50 cases of NT admitted to the intensive care and neonatology units in the Casablanca Children's Hospital between 1990 and 1999. The diagnosis was made on clinical signs and gravity was evaluated with the Dakar score. Results – NT accounts for 0.5% of cases admitted in our service. A low socio-economical level, and home delivery without asepsis were found in 90%. 80% of patients were of rural origin. A Dakar score ⩾4/6 was noted in 76%. Since 1994 therapeutic management has improved but with heavier costs and longer hospitalization. Nevertheless, the mortality rate reached 66%. Conclusion – Prevention based on vaccination, easier access to healthcare, or education of the population will help to solve this problem.

Neonatal adrenal hematoma is a rare condition, most frequently caused by trauma. We report three cases of adrenal hematoma admitted to the Neonatology and Neonatal Intensive Care Unit in the A. Harouchi Children's Hospital, the Ibn Rushd University Hospital in Casablanca, Morocco, over a 2-year period from January 2011 to December 2012. The average age of these patients was 5 days. The clinical presentations were diverse; the most common manifestations were intense jaundice in one case, acute adrenal insufficiency in one case, and severe anemia in the other case. Abdominal ultrasonography was used to confirm the diagnosis and monitor adrenal hemorrhage in all the patients. Analysis of clinical, laboratory, and ultrasonography data showed a favorable prognosis in all the patients. Based on these observations, we discuss the risk factors, clinical presentations, progression and management of neonatal adrenal hemorrhage.