Management of newborns and healthcare workers (HCWs) exposed to congenital tuberculosis (TB) in the neonatal intensive care unit (NICU) has been reported rarely. To outline a contact investigation process for individuals exposed to congenital TB in the NICU and investigate nosocomial transmission. Additionally, to assess the efficacy and safety of window prophylaxis in exposed newborns. A baby, born at a gestational age of 28 + 1 weeks, was diagnosed with isoniazid-resistant congenital TB on the 39th day of admission to the level IV NICU. Newborns and HCWs exposed cumulatively for ≥8 h underwent contact investigation and follow-up for a year. Eighty-two newborns underwent contact investigation. All newborns displayed normal chest X-rays, and 42 hospitalized newborns tested negative for acid-fast bacilli stain and Xpert® MTB/RIF assay in their endotracheal sputum or gastric juices. Eighty received window prophylaxis: six of 75 on rifampin experienced mild adverse events, and none of the five on levofloxacin. After 12 weeks, five (6.1%) had a positive tuberculin skin test, all of whom had already received the Bacillus Calmette–Guérin vaccine and tested negative on TB interferon-gamma releasing assay. Of 119 exposed HCWs, three (2.5%) were diagnosed with latent TB infection and completed a four-month rifampin therapy. There was no active TB disease among exposed newborns and HCWs during a one-year follow-up. Timely diagnosis of congenital TB is crucial for minimizing transmission among exposed neonates and HCWs in the NICU setting. In cases of isoniazid-resistant index patients, even premature newborns may consider the use of rifampin or levofloxacin for window prophylaxis.

中文翻译：

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新生儿重症监护室中接触异烟肼耐药先天性结核病的新生儿和医护人员的管理

对新生儿重症监护病房 (NICU) 中暴露于先天性结核病 (TB) 的新生儿和医护人员 (HCW) 的管理鲜有报道。概述新生儿重症监护室中接触先天性结核病患者的接触者调查流程并调查院内传播。此外，评估暴露新生儿中窗户预防的有效性和安全性。一名出生胎龄28+1周的婴儿在入住IV级新生儿重症监护室第39天被诊断为耐异烟肼先天性结核病。对累计暴露时间≥8小时的新生儿和医护人员进行为期一年的接触者调查和随访。 82 名新生儿接受了接触者调查。所有新生儿的胸部 X 光检查均正常，42 名住院新生儿的气管内痰液或胃液中抗酸杆菌染色和 Xpert® MTB/RIF 检测结果呈阴性。 80 人接受了窗口预防：服用利福平的 75 人中，有 6 人出现了轻度不良事件，而服用左氧氟沙星的 5 人中没有人出现轻微不良事件。 12 周后，五人 (6.1%) 的结核菌素皮试结果呈阳性，所有这些人都已接种了卡介苗，且结核干扰素-γ 释放测定结果呈阴性。在 119 名暴露的医护人员中，三人 (2.5%) 被诊断为潜伏性结核感染，并完成了为期四个月的利福平治疗。在一年的随访期间，暴露的新生儿和医护人员中没有出现活动性结核病。先天性结核病的及时诊断对于最大限度地减少新生儿重症监护病房环境中暴露的新生儿和医护人员之间的传播至关重要。对于异烟肼耐药指数患者，即使是早产儿也可以考虑使用利福平或左氧氟沙星进行窗口预防。