• An audit of syphilis serology in pregnant women attending the Rotunda Hospital 2005 to 2008

      Ciprike, V; Jackson, V; Cafferkey, M; Coulter-Smith, S; Brennan, M; Grundy, KB; Eogan M; Lambert, JS; Rotunda Hospital (2009-02-27)
    • Awareness and Preventative Behaviours Regarding Toxoplasma, Listeria and Cytomegalovirus Among Pregnant Women

      Basit, I; Crowley, D; Geary, M; Kirkham, C; Mc Dermott, R; Cafferkey, M; Sayers, G (Irish Medical Journal, 2019-06)
      Serious fetal infections can be transmitted transplacentally or perinatally. Vaccination is a key prevention method as shown by the dramatic reduction of congenital rubella. Reducing the risk of toxoplasmosis, listeriosis and CMV in pregnancy requires knowledge of their epidemiology and appropriate prevention strategies in the absence of vaccines. Primary infection with Toxoplasma gondii occurs following ingestion of active or inactive cysts. Sources of cysts include undercooked or raw meat (e.g. uncooked or dried meats), contaminated unwashed cooking surfaces and utensils, contaminated cat litter, soil and water supplies, unwashed soil-grown fruits and vegetables, unpasteurised milk, and less frequently, transplanted organs and blood products. Primary toxoplasmosis in pregnancy can lead to chorioretinitis, deafness, microcephaly, developmental delay, late onset of ocular defects, and stillbirth.
    • HIV testing and treatment in the antenatal care setting.

      Coulter-Smith, S; Lambert, J S; Butler, K; Brennan, M; Cafferkey, M; The Rotunda Hospital, Parnell Sq, Dublin 1. (2012-02-01)
      Routine linked HIV antenatal screening, with "opt-out", was introduced at the Rotunda in January 1998. This paper reviews the screening and subsequent pregnancy management and outcome in HIV positive women from 1998 to 2006. During this time 225 women (280 pregnancies) were HIV positive and 194 women subsequently delivered at the Rotunda, representing 233 liveborn infants. Overall anti-HIV prevalence was 0.42%, increasing from 0.06% in 1998 to 0.57% in 2006. Of 233 livebirths, 111 (48%) were delivered by spontaneous vaginal delivery (SVD). HIV treatment was started pre-pregnancy in 14 (6%) pregnancies and antenatally in 208 (90%). The vertical transmission rate in mothers receiving >4 weeks of treatment was 0%. We conclude that routine antenatal HIV screening is effective and significantly benefits the health of mother and child.
    • Imported childhood malaria: the Dublin experience, 1999-2006.

      Leahy, T R; Malikiwi, A; Cafferkey, M; Butler, K M; Department of Paediatrics, Adelaide and Meath Hospitals, incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland. tronanleahy@hotmail.com (2009-09)
      Imported childhood malaria has never been studied in Ireland. We aimed to document the incidence and species of malaria in children presenting to paediatric hospitals in Dublin and to examine management and outcome measures.
    • Infection following cerebrospinal fluid shunt insertion in the Republic of Ireland A retrospective audit

      Burns, K; Caird, J; Allcut, D; Sattar, MTA; Crimmins, D; Gavin, P; Butler, K; Cafferkey, M; Cunney, R (2011-06)
      ESPID 29th Annual Meeting June 2011
    • Infection following external ventricular drain insertion in the Republic of Ireland

      Gavin, P; Butler, K; Cafferkey, M; Cunney, R; Burns, K; Caird, J; Allcut, D; Sattar, MTA; Crimmins, D (2011-06)
      ESPID 29th Annual Meeting
    • Lack of awareness of risk factors for primary toxoplasmosis in pregnancy.

      Ferguson, W; Mayne, P D; Cafferkey, M; Butler, K; Department of Paediatrics, The Rotunda Hospital, Parnell Square, Dublin 1, Ireland. wferguson@rotunda.ie (2011-12)
      The overall seroprevalence of toxoplasma antibodies in women of childbearing age in Ireland is 25% [1]. Hence, 75% of women remain susceptible to primary toxoplasma infection during pregnancy, which if transmitted to the foetus can cause ocular, neurological and other sequelae. Toxoplasma exposure during pregnancy can be avoided if there is an awareness of the potential sources of infection, mainly contaminated food, water, soil and cat faeces.
    • Multiplex PCR to determine Streptococcus pneumoniae serotypes causing otitis media in the Republic of Ireland with further characterisation of antimicrobial susceptibilities and genotypes.

      Vickers, I; O'Flanagan, D; Cafferkey, M; Humphreys, H; Epidemiology and Molecular Biology Unit and Irish Meningococcal and Meningitis Reference Laboratory, Children's University Hospital, Temple St., Dublin, Ireland. imelda.vickers@cuh.ie (2011-03)
      The purpose of this study was to determine the serotypes, genotypes and antimicrobial susceptibilities of Streptococcus pneumoniae causing otitis media (OM) in children in Dublin, Ireland. S. pneumoniae isolates (n = 28) from spontaneously discharging OM were studied. Serotyping was performed using a previously undescribed multiplex polymerase chain reaction (PCR) scheme in combination with serological methods. Multilocus sequence typing (MLST) was performed using standard procedures. Antimicrobial susceptibility testing was performed using the Etest method. Fourteen different S. pneumoniae serotypes were identified. The five most common serotypes were 3, 19F, 19A, 14 and 6A, which accounted for 68% of all infections. The 7-valent pneumococcal conjugate vaccine (PCV7), 10-valent pneumococcal conjugate vaccine (PHiD-CV) and 13-valent pneumococcal conjugate vaccine (PCV13) provided potential coverages of 43%, 46% and 86%, respectively. Reduced susceptibility to penicillin was evident for 25% of isolates and was associated with serotypes 14, 19A, 19F and 9V. A total of 21 different sequence types (STs) were identified. Pneumococcal Molecular Epidemiology Network (PMEN) clones or their variants represented 54% (15/28) of all isolates. Continued monitoring and characterisation of S. pneumoniae causing OM in Ireland is warranted in order to guide future vaccine and treatment policies.
    • A pilot newborn screening programme for congenital toxoplasmosis in the Republic of Ireland

      Mayne, PD; Finnegan, N; Freguson, W; Guy, E; Butler, K; Cafferkey, M; Rotunda Hospital (2009-04)
    • A pilot newborn screening programme for Congenital Toxoplasmosis in the Republic of Ireland

      Mayne, PD; Finnegan, N; Ferguson, W; Guy, E; Bulter, K; Cafferkey, M (2009-04)
    • A pilot newborn screening programme for congenital toxoplasmosis in the Republic of Ireland

      Mayne, PD; Finnegan, N; Ferguson, W; Guy, E; Butler, K; Cafferkey, M; Rotunda Hospital (2009-04)
    • Pneumococcal meningitis: clinical outcomes in a pre-vaccine era at a Dublin paediatric hospital, 1999-2007.

      Lucey, J M; Gavin, P; Cafferkey, M; Butler, K M; Department of Paediatrics, Children's University Hospital, Temple Street, Dublin 1, Ireland. Juliette.Lucey@health.wa.gov.au (2011-03)
      To document the long-term outcomes of pneumococcal meningitis in children presenting to a Dublin paediatric hospital in the pre-pneumococcal conjugate vaccine (PCV7) era (1998-2007).
    • A review of a CMS co ordinate dedicated ID Clinic at a busy inner city maternity hospital

      Coulter-Smith, S; Dr, Brennan, M; Eogan, M; Jackson, V; Lambert, J; Gleeson, J; Ciprike, V; Devitt, S; Cafferkey, M; Grundy, KB; et al. (2009)
    • A review of a CMS co ordinate dedicated ID clinic at a busy inner city maternity hospital

      Coulter –Smith, S; Lambert, JS; Eogan, M; Jackson, M; Ciprike, V; Gleeson, J; Grundy KB; Butler, K; Brennan, M; Cafferkey, M (IPA, 2009-10-15)
    • Serotype distribution of Streptococcus pneumoniae causing invasive disease in the Republic of Ireland.

      Vickers, I; Fitzgerald, M; Murchan, S; Cotter, S; O'Flanagan, D; Cafferkey, M; Humphreys, H; Epidemiology and Molecular Biology Unit and Irish Meningococcal and Meningitis Reference Laboratory, Children's University Hospital, Dublin, Ireland. imelda.vickers@cuh.ie (2011-05)
      The 7-valent pneumococcal conjugate vaccine (PCV7) was included in the routine infant immunization schedule in Ireland in September 2008. We determined the serotype of 977 S. pneumoniae isolates causing invasive disease between 2000-2002 and 2007-2008, assessed for the presence of the recently described serotype 6C and determined the susceptibility of isolates during 2007-2008 to penicillin and cefotaxime. Serotype 14 was the most common serotype during both periods and 7·7% of isolates previously typed as serotype 6A were serotype 6C. During 2000-2002 and 2007-2008, PCV7 could potentially have prevented 85% and 74% of invasive pneumococcal disease in the target population (i.e. children aged <2 years), respectively. The level of penicillin non-susceptibility was 17% in 2007-2008. Ongoing surveillance of serotypes is required to determine the impact of PCV7 in the Irish population and to assess the potential of new vaccines with expanded valency.
    • Should children with inherited metabolic disorders receive varicella vaccination?

      Varghese, M; Cafferkey, M; O'Regan, M; Monavari, A A; Treacy, E P; National Centre for Inherited Metabolic Disorders, Children's University Hospital, Dublin, Ireland. (2011-01)
      The aim was to determine the rate of varicella infection and complications in children with disorders of intermediary metabolism (IEM) between the ages of 1 and 16 years attending our national metabolic referral centre. Of 126 children identified, a response was received from 122. A history of previous varicella infection was identified in 64 cases (53%) and of varicella vaccination in 5 (4%). Fifty-three (43%) patients apparently did not have a history of clinical varicella infection. Of the 64 children with a history of varicella infection, five required hospitalisation for complications, including life-threatening lactic acidosis in one patient with mitochondrial disease and metabolic decompensation in four patients. In conclusion, varicella infection may cause an increased risk of metabolic decompensation in patients with IEMs. We propose that a trial of varicella vaccination be considered for this cohort of patients with monitoring of its safety and efficacy.
    • Should children with inherited metabolic disorders receive varicella vaccination?

      Varghese, M; Cafferkey, M; O'Regan, M; Monavari, A A; Treacy, E P; National Centre for Inherited Metabolic Disorders, Children's University Hospital, Dublin, Ireland. (2011-01)
      The aim was to determine the rate of varicella infection and complications in children with disorders of intermediary metabolism (IEM) between the ages of 1 and 16 years attending our national metabolic referral centre. Of 126 children identified, a response was received from 122. A history of previous varicella infection was identified in 64 cases (53%) and of varicella vaccination in 5 (4%). Fifty-three (43%) patients apparently did not have a history of clinical varicella infection. Of the 64 children with a history of varicella infection, five required hospitalisation for complications, including life-threatening lactic acidosis in one patient with mitochondrial disease and metabolic decompensation in four patients. In conclusion, varicella infection may cause an increased risk of metabolic decompensation in patients with IEMs. We propose that a trial of varicella vaccination be considered for this cohort of patients with monitoring of its safety and efficacy.
    • Stethoscopes: potential reservoirs for the spread of nosocomial infections

      Brennan, L; Grundy, M; Beckett, M; O'Connell, M; Fitzgibbon, A; Brennan, M; Lambert, J; Clarke, T; Cafferkey, M (Poster Presentation: IPA 2009, 2009)
    • Susceptibility of pregnant women to toxoplasma infection--potential benefits for newborn screening.

      Ferguson, W; Mayne, P D; Lennon, B; Butler, K; Cafferkey, M; The Rotunda Hospital, Parnell Street, Dublin. wferguson@rotunda.ie (2008-08-20)
      Congenital toxoplasmosis (CT) arises as a result of new acquisition of Toxoplasma infection by a susceptible woman during pregnancy. Early detection of CT through neonatal screening programmes could optimize management and improve infant outcome. This study sought to estimate the prevalence of Toxoplasma susceptibility in pregnant women. As detection of Toxoplasma antibodies in neonatal blood reflects maternal exposure history, maternal antibody seroprevalence was determined using anonymized residual blood from newborn screening cards. A total of 20,252 cards were tested in 1 year. 4,991 (24.6%) cards tested positive for Toxoplasma antibody. Results were stratified by county. Toxoplasma antibody seroprevalence rates of 25% indicated that Toxoplasma infection is common in Ireland and that up to 75% of women remain susceptible to primary infection during pregnancy. This study aimed to a) determine the seroprevalence of Toxoplasma antibody in pregnant women, and hence b) estimate the risk for acquisition of primary toxoplasmosis in pregnancy in order to support an application to fund a pilot newborn screening programme.