title: [Neonatal exposure to active pulmonary tuberculosis in a maternity ward: screening and clinical course of a cohort of exposed infants].
abstract: Few data are available on the impact of a tuberculosis exposure on newborns in a maternity ward.
  
  
  OBJECTIVE
  To describe the screening and clinical course of infants exposed during the neonatal period to a caregiver with bacillary tuberculosis.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Service de pédiatrie générale, hôpital Robert-Debré, Assistance Publique des hôpitaux de Paris, 48 boulevard Sérurier, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Perry
authors.forename: F
authors.initials: F
authors.lastname: Angoulvant
authors.forename: K
authors.initials: K
authors.lastname: Chadelat
authors.forename: A
authors.initials: A
authors.lastname: De Lauzanne
authors.forename: V
authors.initials: V
authors.lastname: Houdouin
authors.forename: A
authors.initials: A
authors.lastname: Kheniche
authors.forename: M
authors.initials: M
authors.lastname: Lorrot
authors.forename: B
authors.initials: B
authors.lastname: Mesples
authors.forename: V
authors.initials: V
authors.lastname: Nouyrigat
authors.forename: Y
authors.initials: Y
authors.lastname: Aujard
authors.forename: J
authors.initials: J
authors.lastname: Gaudelus
authors.forename: E
authors.initials: E
authors.lastname: Grimprel
authors.forename: A
authors.initials: A
authors.lastname: Faye
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003428:Cross Infection / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D017757:Infectious Disease Transmission, Professional-to-Patient; D007538:Isoniazid / Q000627:therapeutic use; D055985:Latent Tuberculosis / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission*; D008297:Male; D008400:Mass Chest X-Ray; D008403:Mass Screening; D009775:Obstetrics and Gynecology Department, Hospital; D010297:Paris; D012293:Rifampin / Q000627:therapeutic use; D012307:Risk Factors; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission*
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin