INTRODUCTION Limited studies have explored the clinical features, treatment, and prognosis of neonatal tuberculosis (TB). Here, we attempted to delineate the clinical characteristics of neonatal TB, which may help clinicians further understand this disease. METHODS A retrospective analysis of neonates diagnosed with congenital and/or neonatal TB disease from January 2010 to December 2020 was performed. Information on the demographic and epidemiological features, clinical symptoms, laboratory and imaging examinations, therapeutic regimens, and outcomes was collected. Kaplan-Meier analysis was used to present the time to disease onset, time to diagnosis, etc. Results: Forty-eight cases of neonatal TB were classified into congenital (n = 33) and postnatal (n = 15). The median time to disease onset in postnatal group was significantly longer than that in congenital group. Positive results for gastric fluid acid-fast bacilli, TB culture, Xpert MTB/RIF, interferon-γ release assay (IGRA), and tuberculin skin test were detected in 26/48 (54.2%), 14/34 (41.2%), 11/18 (61.1%), 19/29 (65.5%), and 8/24 (33.3%) patients, respectively. For lymphadenopathy, computed tomography (CT) scans showed a higher detection rate than did X-ray (80.0% vs. 0). Of the 48 infants, 44/48 (91.7%) received anti-TB therapy, and 33/44 (75%) were clinically improved or cured after 22.1 months (interquartile range: 12.4-27.7) of follow-up. Drug-induced liver injury occurred in 14/44 (31.8%) patients. DISCUSSION/CONCLUSION IGRA and Xpert MTB/RIF showed good positive rate in neonatal TB infection/disease. In cases where TB is presumed but etiological evidence is lacking, low-dose CT could be considered. Prompt treatment under careful surveillance is important for preventing mortality and avoiding severe adverse effects.

中文翻译：

---

先天性和新生儿结核病的临床特征、诊断和治疗：回顾性研究。

简介 探索新生儿结核病 (TB) 的临床特征、治疗和预后的研究有限。在这里，我们试图描述新生儿结核病的临床特征，这可能有助于临床医生进一步了解这种疾病。方法对2010年1月至2020年12月诊断患有先天性和/或新生儿结核病的新生儿进行回顾性分析。收集了有关人口统计学和流行病学特征、临床症状、实验室和影像学检查、治疗方案和结果的信息。采用Kaplan-Meier分析来呈现发病时间、诊断时间等。结果：48例新生儿结核病分为先天性（n = 33）和后天性（n = 15）。后天组的中位发病时间明显长于先天组。胃液抗酸杆菌、结核培养、Xpert MTB/RIF、干扰素-γ释放测定（IGRA）和结核菌素皮试检测呈阳性结果的患者分别为 26/48（54.2%）、14/34（41.2%）、分别为 11/18 (61.1%)、19/29 (65.5%) 和 8/24 (33.3%) 患者。对于淋巴结肿大，计算机断层扫描 (CT) 扫描的检出率高于 X 射线（80.0% vs. 0）。48 名婴儿中，44/48（91.7%）接受了抗结核治疗，33/44（75%）在随访 22.1 个月（四分位距：12.4-27.7）后临床改善或治愈。14/44 (31.8%) 患者发生药物性肝损伤。讨论/结论 IGRA 和 Xpert MTB/RIF 在新生儿结核感染/疾病中显示出良好的阳性率。如果推测患有结核病但缺乏病原学证据，可以考虑低剂量 CT。在仔细监测下及时治疗对于预防死亡和避免严重不良反应非常重要。