ro13-9904 and Syphilis--Congenital

Congenital syphilis is a prevalent infection in much of the world but rare in contexts where antenatal screening and treatment are available. In the UK in 2016, three cases of congenital syphilis were reported in babies born to women who were seronegative at the time of booking and hence a high degree of clinical vigilance is required in the unwell infant. We present the case of a seven-week-old baby girl with congenital syphilis with the unusual finding of discrete liver lesions. This baby was successfully treated with intravenous ceftriaxone.

Topics: Administration, Intravenous; Administration, Oral; Biopsy; Bones of Lower Extremity; Ceftriaxone; Female; Humans; Infant, Newborn; Liver; Magnetic Resonance Imaging; Penicillin V; Pregnancy; Pregnancy Complications, Infectious; Syphilis, Congenital; Treatment Outcome; Treponema pallidum; Ultrasonography

 The present study assessed epidemiological and obstetrical data from pregnant women with syphilis at the Hospital de Clínicas of the Universidade Federal do Triângulo Mineiro (UFTM, in the Portuguese acronym), describing this disease during pregnancy and its vertical transmission for future healthcare actions..  Records from pregnant women who had been admitted to the Obstetrics Department of the Hospital de Clínicas of the UFTM and were diagnosed with syphilis between 2007 and 2016 were reviewed. A standardized form was used to collect epidemiological, obstetric data and outcomes of congenital infection. The present research has been authorized by the Ethics Committee of the institution..  There were 268 women diagnosed with syphilis, with an average age of 23.6 years old. The majority of the patients were from Uberaba. Inadequate prenatal care was observed in 37.9% of the pregnant women. Only 34.2% of the patients completed the treatment according to the guidelines issued by the Ministry of Health of Brazil, and 19.8% of the partners of the patients underwent adequate syphilis treatment; 37 (13.8%) couples (patients and partners) underwent correct treatment. Regarding the obstetric outcomes, 4 (1.5%) patients had a miscarriage and 8 (3.4%) had fetal losses (from the fetal loss group, 7 had no adequate treatment); 61 (25.9%) patients had premature births - this prematurity has been significantly correlated to inadequate or incomplete treatment in 49 (27.9%) patients, compared with 12 (13.0%) patients with premature births and adequate treatment (.  Public awareness policies on adequate prenatal care, intensification of serological screening, and early treatment of syphilis are needed, considering the rise of cases diagnosed during gestation and its potentially preventable deleterious consequences related to congenital transmission..  O presente estudo avaliou dados epidemiológicos e obstétricos de gestantes com sífilis no Hospital de Clínicas da Universidade Federal do Triângulo Mineiro (UFTM), objetivando o conhecimento desta infecção no ciclo gravídico e a transmissão vertical para futuras ações em saúde pública. MéTODOS::  Foram revisados registros de gestantes admitidas no Departamento de Ginecologia e Obstetrícia do Hospital de Clínicas da UFTM, diagnosticadas com sífilis entre 2007 e 2016. Para a coleta de dados, utilizou-se um formulário padronizado enfocando aspectos epidemiológicos, obstétricos e infecção congênita. A presente pesquisa foi autorizada pelo Comitê de Ética da instituição.

Topics: Anti-Bacterial Agents; Brazil; Ceftriaxone; Drug Administration Schedule; Female; Hospitalization; Hospitals, Public; Humans; Infant, Newborn; Male; Penicillin G Benzathine; Pregnancy; Pregnancy Complications, Infectious; Prenatal Diagnosis; Prognosis; Retrospective Studies; Syphilis; Syphilis, Congenital; Treatment Outcome; Young Adult

Topics: Anti-Bacterial Agents; Ceftriaxone; Fingers; Humans; Infant; Male; Radiography; Syphilis, Congenital; Treatment Outcome; Treponema pallidum

Ceftriaxone concentrations in sera of females at various terms of pregnancy and in certain organs and tissues of the fetus were assayed. The antibiotic was administered intramuscularly in doses of 1.0 and 0.5 g once a day. The concentrations were estimated by HPLC. The ceftriaxone levels in the specimens were tens times higher than the minimal treponemocidal concentration (0.01 mcg/ml). The doses were sufficient for the prophylaxis of hereditary syphilis. Meanwhile, the clinical practice indicated that duration of the ceftriaxone prophylaxis of the pregnant females should be increased.

Topics: Anti-Bacterial Agents; Ceftriaxone; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Syphilis, Congenital; Tissue Distribution