Practical recommendations for neonatologists and pediatricians “Congenital ureaplasma, mycoplasma and chlamidia infections” (Draft of clinical recommendations for discussion by specialists)

Congenital chlamydia infection develops as a result of the intranatal transmission of the pathogen Chlamydia trachomatis from mother to fetus, more often occurs in the form of conjunctivitis, symptoms of which appear in the second to third weeks of a child’s life, or atypical pneumonia developing at 2–3 months of an infant’s life. The clinical picture of the pneumonia is characterized by an obsessive paroxysmal whooping pertussis-like cough with a moderately pronounced symptom of intoxication. Rare manifestations and complications of chlamydial infection in the form of encephalitis, myocarditis, recurrent otitis media in children under 6 months of age are described. Congenital ureaplasma and mycoplasma infection caused by pathogenic or opportunistic types of urogenital mycoplasmas and ureaplasmas more often occurs in the form of atypical pneumonia, which develops in 2–3 weeks of a child’s life. It is characterized by a gradual onset with catarrhal syndrome with the addition of a dry, intense paroxysmal cough with a moderately pronounced intoxication syndrome. In premature infants, the course of the disease is more severe, cases of meningitis, sepsis, and myocarditis have been described. Ureaplasma infection is one of the independent risk factors for the development of bronchopulmonary dysplasia and retinopathy in premature infants. The main criterion for the diagnosis of congenital ureaplasma, mycoplasma or chlamydia infection is the isolation of the deoxyribonucleic acid of the pathogen in biological media by polymerase chain reaction in the presence of clinical and/or laboratory data For the treatment of chlamydia, ureaplasma and mycoplasma infections in newborns and young children, antibacterial drugs from the macrolide group are used in most cases The duration of the course of therapy and the method of administration depends on the severity of the clinical manifestations of infection in the child, the results of laboratory and instrumental studies.