Abstract:
BACKGROUND:In the German guidelines for prophylaxis of group B streptococcal (GBS) early onset sepsis in neonates (EOS), GBS screening of all pregnant women has been recommended, but is not yet included in the Maternity Directives. Aim of the study was to identify temporal trends in incidence of EOS and their association to GBS Screening. METHODS:The analysis based on health insurance data of the statutory health insurance provider Barmer from 2005 to 2017 of 313,385 mother-child pairs. Annual frequency of GBS infections in newborns was determined by ICD-10 P36.0. The frequency of maternal GBS colonization was indicated by ICD-10 B95.1, which was used as surrogate for GBS screening. Temporal trends of the risk of EOS in neonates were assessed in logistic regression models. Pearson's correlation coefficient of EOS incidence and the surrogate marker for maternal GBS colonization was calculated. RESULTS:The risk of EOS in neonates caused by GBS has decreased annually by 9.3%, resulting in an overall decrease in the observation period of 72.0%. There was no statistical significant change in the risk for LOS (Late Onset Sepsis). The decrease of EOS could not be explained by temporal changes in Caesarian section, risk factors or preterm delivery. The 3.5 fold increase in the proportion of mothers with documented positive GBS colonization in the same period correlated inversely with the incidence of EOS (r=- 0.75; p=0.002). CONCLUSION:The decrease of EOS in neonates caused by GBS in Germany and the unchanged risk of LOS in neonates may be explained by the increasing application of the GBS Screening in pregnant women. HINTERGRUND:In der Leitlinie zur Prophylaxe der frühen Form (Early Onset Sepsis, EOS) der Neugeborenensepsis durch Streptokokken der Gruppe B (GBS) wird ein GBS Screening aller Schwangeren empfohlen. Dieses ist jedoch nicht Bestandteil der Mutterschaftsrichtlinien. Studienziel war die Überprüfung des zeitlichen Verlaufs der Infektionsrate im Zusammenhang mit dem GBS Screening. METHODIK:Krankenversicherungsdaten der Jahre 2005 bis 2017 von 313 385 BARMER versicherten Mutter-Kind Paaren wurden analysiert. Über die ICD-10 P36.0 wurde die jährliche Häufigkeit von GBS Infektionen bei Neugeborenen ermittelt. Als Surrogat für das GBS Screening wurde die ICD-10 B95.1 verwendet, welche bekannte positive mütterliche GBS Besiedelung beschreibt. Durch logistische Regressionsmodelle wurden die zeitliche Veränderungen des Erkrankungsrisikos von EOS bei Neugeborenen untersucht. Pearson-Korrelationskoeffizient wurde zur Bewertung des Zusammenhangs zwischen der zeitlichen Veränderung der Häufigkeit an EOS und dem Surrogatmarker für GBS Besiedelung verwendet. ERGEBNISSE:Das Erkrankungsrisiko der EOS bei Neugeborenen hat jährlich um 9,3% abgenommen, gesamt über die Beobachtungsjahre um 72,0%, während für die Spätform LOS (Late Onset Sepsis) keine statistisch signifikante Veränderung beobachtet wurde. Diese Abnahme konnte nicht durch zeitliche Veränderungen bei Kaiserschnitten, Risikofaktoren oder Frühgeburten erklärt werden. Eine gleichzeitige Erhöhung des Anteils der Mütter mit bekanntem positivem GBS Status um den Faktor 3,5 korrelierte invers (r=− 0,75; p=0,002) mit der Inzidenz von EOS. SCHLUSSFOLGERUNG:Die starke Abnahme der EOS in Deutschland bei unveränderter Inzidenz von LOS könnte durch eine zunehmende Umsetzung des Schwangerenscreenings erklärt werden.
journal_name
Klin Padiatrjournal_title
Klinische Padiatrieauthors
Sorg AL,Obermeier V,Armann J,Klemme M,von Kries Rdoi
10.1055/a-1202-1758subject
Has Abstractpub_date
2021-01-01 00:00:00pages
17-23issue
1eissn
0300-8630issn
1439-3824journal_volume
233pub_type
杂志文章abstract::Megestrol acetate (MA) is a synthetic, orally active derivative of the naturally occurring hormone progesterone. MA is increasingly used to correct loss of appetite and improve the nutritional status. We used MA in an adolescent with growth hormone (GH) deficiency due to former irradiation therapy in order to evaluate...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2002-25268
更新日期:2002-03-01 00:00:00
abstract::We present three cases of GC, one belonging to the brainstem, and two belonging to the hemisphere type. Two cases were investigated by MRI. Tumour infiltration, while yielding only vague CT findings, was well demonstrated in MR studies where extensive hyperintense lesions were found in T2- and proton density images. I...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2007-1025450
更新日期:1991-09-01 00:00:00
abstract::Severe anaphylactic reactions were observed in 2 children, aged 2 and 14 years, with acute lymphocytic leukemia and a 12 month old infant with a functional T-cell defect after intravenous administration of a polyethyleneglycol (PEG)-treated immunoglobulin preparation. All 3 children suffered additionally from hypogamm...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1026802
更新日期:1987-07-01 00:00:00
abstract:HINTERGRUND: Die zeitliche Verzögerung zwischen Symptombeginn und Diagnose ist eine Herausforderung in der Behandlung von Kindern mit arteriell ischämischem Schlaganfall. Frühere Studien zur klinischen Präsentation beschäftigten sich v. a. mit kumulativen Symptomen. ZIELSETZUNG: Ziel dieser Studie ist es, mögliche Sym...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/a-0684-9794
更新日期:2018-10-01 00:00:00
abstract::Cytological examination of cerebrospinal fluid needs special techniques of cell collecting and staining. On condition of realizing the methodical requirements cytology of the cerebrospinal fluid brings more advancement in diagnostics than other laboratory examinations. The advantages of this procedure are: 1. Meningit...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1975-03-01 00:00:00
abstract:BACKGROUND:Due to rising survival rates in cancer and autoimmune diseases fertility preservation before gonadotoxic therapies has become increasingly important. Although fertility can be significantly affected by gonadotoxic therapies, the possibility of fertility preservation during childhood has not been sufficiently...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-0044-100396
更新日期:2018-02-08 00:00:00
abstract::The integration of colleagues from psychosocial occupations into the traditional team of doctors and nurses demands a holistic treatment concept, the general desire for interdisciplinary action, and readiness for patience in the process of mutual learning. The acceptance of the psychosocial services by the patient and...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1026726
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:The association between Hepatitis B virus infection and membranous nephropathy has been confirmed by sources in several countries. Most commonly, the illness is seen as a nephrotic syndrome. Optimal treatment remains undefined. Antiviral therapies observed with recombinant human interferon alpha may be the b...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2000-9689
更新日期:2000-09-01 00:00:00
abstract::Report of a case of the fetal face syndrome associated with severe oligophrenia and septum pellucidum cyste in a male patient aged 30 years. The case demonstrates the good prognosis of the hypogenitalism resp. small genitalia; the correct diagnosis in this syndrome can the patients save a plastic of the penis. ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1046568
更新日期:1995-11-01 00:00:00
abstract::In 25 very low birth weight infants appropriate for gestational age the influences of different human milk (HM) preparations on weight gain, gross indices of nitrogen metabolism and energy balance were studied during the second month of postnatal life. HM was fortified either by HM-protein (HMP) or by an enzymatic mea...
journal_title:Klinische Padiatrie
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-1025538
更新日期:1990-09-01 00:00:00
abstract::Ten to fifteen percent of infants of myasthenic mothers develop neonatal myasthenia independent of the severity of the maternal disease. The antiacetylcholin receptor-protein antibodytiter (AChR-AK) was followed through the first twelve months in a boy who's mother suffered from myasthenia gravis (M.G.) since twelve y...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1034089
更新日期:1984-09-01 00:00:00
abstract::Iron concentration was determined by the aid of the ESA Ferrochem 3050 analyzer and the bathophenanthroline method with deproteinization. Both methods showed a good precision and accuracy. The investigation was carried out in 505 sera with an iron concentration between 9 and 333 micrograms/dl. The comparison of the tw...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1033773
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:Modern neonatal and pediatric intensive care includes a sophisticated pharmacotherapy with numerous drugs, mainly administered intravenously. Often, despite the use of multi-lumen central venous lines, more peripheral venous accesses are required. To reduce the necessity of numerous venous lines on one hand ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2005-836937
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:To investigate the change of psychological symptoms and quality of life in children and adolescents with congenital heart disease, cancer, or cystic fibrosis after a family-oriented inpatient rehabilitation program. METHODS:302 participants in the intervention (aged 4-17 years, mean=8.7) were assessed using ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-0030-1262831
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Gender differences in overall neonatal survival and in short term pulmonary outcome have been reported. Furthermore gender differences in childhood chronic lung disorders have been described all in favor of females. METHODS:A typical survey on published data regarding gender differences in lung development ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/s-0033-1333758
更新日期:2013-03-01 00:00:00
abstract::Five patients with arteriovenous angiomas in the head (2 galea angiomas, 1 mixed form with extracranial and intracranial localization of the arteriovenous fistulas and 2 intracranial arteriovenous fistulas) were described. Four patients were examined as newborns or infants. Oximetric data, intracardial pressure and ci...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1976-05-01 00:00:00
abstract::The biologic behaviour of teratomas depends on various interdependent clinical and epidemiologic variables such as the age at diagnosis, sex, tumor site, histology which all correlate to different cytogenetic and molecular biologic aberrations. Thus, testicular teratomas of infancy are generally benign. Accordingly, p...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2006-942271
更新日期:2006-11-01 00:00:00
abstract::A follow-up study was undertaken to determine the predictors of the course of recurrent wheezing episodes in children (between 0 to 8 years). In 1991, 600 children with wheezing episodes had been recorded by physicians who participated in a sentinel practice network. On each consultation with the same physicians from ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1043843
更新日期:1998-01-01 00:00:00
abstract::On our opinion one important indication for sonographic diagnosis in future are masses in the larynx area: in infancy or childhood mainly laryngeal papillomatosis. In one of our boy patients with massive laryngeal papillomatosis laser surgery was first performed at 15 months of age. After a second and third procedure ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2007-1025304
更新日期:1989-05-01 00:00:00
abstract::Immune neutropenia in infancy comprises alloimmune neutropenia and autoimmune neutropenia. Both diseases are caused by granulocyte-specific antibodies. Patients are newborns and children, often being younger than three years. Neutropenia usually leads to recurrent mild bacterial infections. Beside the blood count and ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1026742
更新日期:1989-11-01 00:00:00
abstract::Infectious complications are a major cause of morbidity and mortality in pediatric and adult patients undergoing hematopoietic stem cell transplantation. The incidence and the severity code of infections depend on the function of the host's immune system. This function is strongly correlated to the application of immu...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/s-2005-872508
更新日期:2005-11-01 00:00:00
abstract::While many aspects related to the etiology and pathogenesis of sudden infant death remain unclear, the ultimate trigger event appears to be an acute regulatory disturbance of the cardiorespiratory neurons of the reticular formation of the brain stem. Retrospective studies have demonstrated that SIDS often occurs after...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2007-1025334
更新日期:1992-03-01 00:00:00
abstract::This is a case-report about a 4 year old boy with "cherry red" epiglottis, purulent meningitis and pleuropneumonia. Purulent meningitis and pleuropneumonia are not complications of treatment of "cherry red" epiglottis but an entity caused by Hemophilus influenzae-infection and is called Kleinschmidt's syndrome (Hemoph...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1976-07-01 00:00:00
abstract::Meconium ileus equivalent (MIE) complicating cystic fibrosis of the pancreas (CF) increases in frequently with increasing age of patients. In the present paper the course of 11 children and adolescents with MIE diagnosed and treated at the University Dept. of Paediatrics in Zürich during the last 15 years, i.e. 9% of ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1034390
更新日期:1983-09-01 00:00:00
abstract::Review of a rare multisystem disorder with the main symptoms achalasia of the esophagus, alacrimia and glucocorticoid deficiency as well as multiple other symptoms especially of the nervous system. Report of one case diagnosed in the age of 11.5 years with a case history of about 7 years. Description of the danger to ...
journal_title:Klinische Padiatrie
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1046527
更新日期:1995-05-01 00:00:00
abstract::From 1968--1978 a longitudinal study was performed concerning development of thorax, upper arm, thigh and calf circumferences in 709 boys and 711 girls 2--15 years old. In boys the mean increase in thoracic circumference amounted to 32.9 cm, in upper are circumference to 8.3 cm, in thigh circumference to 20.6 cm and i...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1033856
更新日期:1980-01-01 00:00:00
abstract::Hepatotoxicity of valproic acid (VPA) is reported in a psychomotor retarded boy. A four-month antiepileptic therapy was followed by a combined VPA/phenytoin treatment where-upon, two months later, the patient died in a hepatic coma. In the final state the metabolic pattern of VPA was still found within the normal rang...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-2008-1034017
更新日期:1985-09-01 00:00:00
abstract:BACKGROUND:Intrauterine growth restriction seems to be a risk factor for an aggravated course of secondary renal diseases in children. Catch-up growth after birth may play a critical role. We tested if there is an association between an aggravated course of nephritis in Henoch-Schönlein Purpura (PSHN) and low birth wei...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:10.1055/s-0030-1263135
更新日期:2010-12-01 00:00:00
abstract::Prognostic factors to estimate the risk of relapse are crucial for risk-adapted therapy in acute lymphoblastic leukemia (ALL). In a cooperative multicenter treatment study for childhood ALL (COALL-03-85) the prognostic relevance of the bone marrow (BM) blast count at day 28 was evaluated. Treatment was adjusted to the...
journal_title:Klinische Padiatrie
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1055/s-2007-1025434
更新日期:1991-07-01 00:00:00
abstract::Problems of terminology, differential diagnosis, etiology and therapy of language development disorders are demonstrated by a casuistic example. Besides the importance of clinical date special attention was laid on neuropsychological diagnostic procedures and their therapeutic implications. Therapeutic interventions c...
journal_title:Klinische Padiatrie
pub_type: 杂志文章
doi:
更新日期:1978-09-01 00:00:00