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Sepsis And Newborn

Rachael F Grace, Paola Bianchi, Eduard J van Beers, Stefan W Eber, Bertil Glader, Hassan M Yaish, Jenny M Despotovic, Jennifer A Rothman, Mukta Sharma, Melissa M McNaull, Elisa Fermo, Kimberly Lezon-Geyda, D Holmes Morton, Ellis J Neufeld, Satheesh Chonat, Nina Kollmar, Christine M Knoll, Kevin Kuo, Janet L Kwiatkowski, Dagmar Pospíŝilová, Yves D Pastore, Alexis A Thompson, Peter E Newburger, Yaddanapudi Ravindranath, Winfred C Wang, Marcin W Wlodarski, Heng Wang, Susanne Holzhauer, Vicky R Breakey, Joachim Kunz, Sujit Sheth, Melissa J Rose, Heather A Bradeen, Nolan Neu, Dongjing Guo, Hasan Al-Sayegh, Wendy B London, Patrick G Gallagher, Alberto Zanella, Wilma Barcellini
An international, multicenter registry was established to collect retrospective and prospective clinical data on patients with pyruvate kinase (PK) deficiency, the most common glycolytic defect causing congenital non-spherocytic hemolytic anemia. Medical history and laboratory and radiologic data were retrospectively collected at enrollment in 254 patients with molecularly confirmed PK deficiency. Perinatal complications were common, including anemia requiring transfusions, hyperbilirubinemia, hydrops, and prematurity...
March 16, 2018: Blood
Ramiro Manzano Núñez, James Alejandro Zapata, Herney A García-Perdomo, Diego A Gomez, Mónica A Solís Velasco
INTRODUCTION: Few reports are available about perinatal dengue, with controversial results in regards the risk of perinatal outcome. OBJECTIVE: To report a case of perinatal dengue as a differential diagno sis with neonatal sepsis, which must be considered in endemic areas. CLINICAL CASE: Male newborn of a 23 year-old female, who presented a Non-Structural Protein 1 (NS1) antigen positive to dengue at 36 weeks of gestation and negative anti-dengue antibodies...
December 2017: Revista Chilena de Pediatría
Cinta Moraleda, Rachid Benmessaoud, Jessica Esteban, Yuly López, Hassan Alami, Amina Barkat, Tligui Houssain, Meryem Kabiri, Rachid Bezad, Saad Chaacho, Lola Madrid, Jordi Vila, Carmen Muñoz-Almagro, Jordi Bosch, Sara M Soto, Quique Bassat
PURPOSE: Group B streptococcus (GBS) is an important cause of neonatal sepsis worldwide. Data on the prevalence of maternal GBS colonization, risk factors for carriage, antibiotic susceptibility and circulating serotypes are necessary to tailor adequate locally relevant public health policies. METHODOLOGY: A prospective study including pregnant women and their newborns was conducted between March and July 2013 in Morocco. We collected clinical data and vagino-rectal and urine samples from the recruited pregnant women, together with the clinical characteristics of, and body surface samples from, their newborns...
March 15, 2018: Journal of Medical Microbiology
Sammy M Tabbah, Catalin S Buhimschi, Katherine Rodewald-Millen, Christopher R Pierson, Vineet Bhandari, Philip Samuels, Irina A Buhimschi
OBJECTIVE:  Hepcidin, a mediator of innate immunity, binds the iron exporter ferroportin, leading to functional hypoferremia through intracellular iron sequestration. We explored hepcidin-ferroportin interactions in neonates clinically diagnosed with early-onset neonatal sepsis (EONS). STUDY DESIGN:  Hepcidin and interleukin (IL)-6 were quantified by enzyme-linked immunosorbent assay (ELISA) in 92 paired cord blood-maternal blood samples in the following groups: "Yes" EONS ( n  = 41, gestational age [GA] 29 ± 1 weeks) and "No" EONS ( n  = 51, GA 26 ± 1 weeks)...
February 2, 2018: American Journal of Perinatology
Rachel Levene, Elza Pollak-Christian, Ashish Garg, Michael Keenaghan
Coarctation of the aorta (CoA) is a congenital cardiac malformation that is well understood. Despite being well characterized, CoA is a commonly missed congenital heart disease (CHD) during the newborn period. We report a full-term nine-day-old male who presented to the pediatric emergency department (ED) with isolated tachypnea. After an initial sepsis workup, subsequent investigations revealed critical CoA. Because the primary workup focused on sepsis, there was a significant delay in prostaglandin E1 (PGE1 ) initiation...
2018: Case Reports in Pediatrics
Miry Shim, Sara Yang, Catherine R Messina, Jonathan P Mintzer
PURPOSE: To compare discharge breastmilk feeding rates among asymptomatic term newborns receiving 48-hour versus >48-hour antibiotics in the neonatal intensive care unit (NICU) and a cohort of well-baby nursery (WBN) newborns. MATERIALS AND METHODS: This retrospective review included asymptomatic term neonates admitted to the NICU due to maternal chorioamnionitis and a comparison group of WBN neonates between January 2012 and December 2015. Demographic, birth, feeding, and lactation consultant visit data were analyzed in univariate and multivariate models...
March 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
Manju Ohri, Smriti Parashar, Venkatesh S Pai, Sujata Ghosh, Anuradha Chakraborti
Group B streptococcus (GBS) or Streptococcus agalactiae, is an opportunistic pathogen causing a wide range of infections like pneumonia, sepsis, and meningitis in newborn, pregnant women and adults. While this bacterium has adapted well to asymptomatic colonization of adult humans, it still remains a potentially devastating pathogen to susceptible infants. Advances in molecular techniques and refinement of in vitro and in vivo model systems have elucidated key elements of the pathogenic process, from initial attachment to the maternal vaginal epithelium to penetration of the newborn blood-brain barrier...
March 8, 2018: World Journal of Microbiology & Biotechnology
Tobias Strunk, Ashok Buchiboyina, Mary Sharp, Elizabeth Nathan, Dorota Doherty, Sanjay Patole
BACKGROUND: Early-onset sepsis (EOS) is a potentially fatal condition that affects about 0.3-0.8/1,000 infants born at ≥35 weeks' gestation in developed countries. Current EOS management algorithms result in 8-15% of infants receiving antibiotics for suspected sepsis. The Neonatal Sepsis Calculator provides evidence-based estimates of individual sepsis risk, but data on its clinical application is limited. OBJECTIVES: To evaluate the feasibility, safety, and effect on the newborn infants that were investigated and that received antibiotic treatment for suspected EOS following the introduction of the Neonatal Sepsis Calculator...
March 7, 2018: Neonatology
Rowena L McMullan, Adrienne Gordon
BACKGROUND: Late-onset sepsis is associated with increased rates of mortality and morbidity in newborn infants, in addition to poorer long-term developmental outcomes and increased length of stay and hospital costs. Central line-associated blood stream infection (CLABSI) is the most common cause of late-onset sepsis in hospitalised infants, and prevention of CLABSI is a key objective in neonatal care. Increased frequency of CLABSI around the time of removal of central venous catheters (CVCs) has been reported, and use of antibiotics at the time of removal may reduce the incidence and impact of late-onset sepsis in vulnerable newborn infants...
March 7, 2018: Cochrane Database of Systematic Reviews
David A Osborn, Tim Schindler, Lisa J Jones, John Kh Sinn, Srinivas Bolisetty
BACKGROUND: Sick newborn and preterm infants frequently are not able to be fed enterally, necessitating parenteral fluid and nutrition. Potential benefits of higher parenteral amino acid (AA) intake for improved nitrogen balance, growth, and infant health may be outweighed by the infant's ability to utilise high intake of parenteral AA, especially in the days after birth. OBJECTIVES: The primary objective is to determine whether higher versus lower intake of parenteral AA is associated with improved growth and disability-free survival in newborn infants receiving parenteral nutrition...
March 5, 2018: Cochrane Database of Systematic Reviews
Satyan Lakshminrusimha, Seetha Shankaran, Abbot Laptook, Scott McDonald, Martin Keszler, Krisa Van Meurs, Ronnie Guillet, Sanjay Chawla, Beena G Sood, Sonia Bonifacio, Abhik Das, Rosemary D Higgins
OBJECTIVE: To determine the characteristics of term infants with persistent pulmonary hypertension of the newborn (PPHN) associated with moderate or severe hypoxic ischemic encephalopathy (HIE). METHODS: We compared infants with and without PPHN enrolled in 2 randomized trials of therapeutic hypothermia: the induced hypothermia trial of cooling to 33.5°C for 72 hours vs normothermia, and the "usual-care" arm (33.5°C for 72 hours) of the optimizing cooling trial...
March 1, 2018: Journal of Pediatrics
Irene A Stafford, Eliza Rodrigue, Alexandra Berra, Wesley Adams, Asha J Heard, Joseph L Hagan, Shawn J Stafford
BACKGROUND: Necrotizing enterocolitis (NEC) is a leading cause of newborn gastrointestinal emergencies, affecting 1-3 per 1000 live births. Although NEC has been linked to a microbial etiology, associations with maternal intrapartum and resultant newborn early-onset invasive Group B streptococcus (EO-GBS) have been weakly defined. OBJECTIVE: The study aim was to determine the relationship between EO-GBS and NEC. STUDY DESIGN: Data from 2008 to 2015 were collected from pediatric records with ICD diagnosis codes consistent with all stages of NEC, with the exception of neonatal EO-GBS data (only available 2011-2015)...
February 24, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Melissa C Morgan, Harriet Nambuya, Peter Waiswa, Cally Tann, Diana Elbourne, Janet Seeley, Elizabeth Allen, Joy E Lawn
Background: Kangaroo mother care (KMC) for stable neonates ≤2000 g (g) is associated with decreased mortality, sepsis, hypothermia, and length of stay compared to conventional care. The World Health Organization states that KMC "should be initiated… as soon as newborns are clinically stable " [12]. However, the majority of deaths occur in unstable neonates. We aimed to determine the proportion of admitted neonates meeting proposed instability criteria, assess the feasibility of providing KMC to unstable neonates, and evaluate the acceptability of this intervention to parents and providers at Jinja Regional Referral Hospital in Uganda...
June 2018: Journal of Global Health
Perlinot Herindrainy, Mamitiana Alain Noah Rabenandrasana, Zafitsara Zo Andrianirina, Feno Manitra Jacob Rakotoarimanana, Michael Padget, Agathe de Lauzanne, Awa Ndir, Elsa Kermorvant-Duchemin, Benoit Garin, Patrice Piola, Jean-Marc Collard, Didier Guillemot, Bich-Tram Huynh, Elisabeth Delarocque-Astagneau
In low and middle income countries (LMICs), where the burden of neonatal sepsis is the highest, the spread of extended spectrum beta-lactamase-producing enterobacteriaceae (ESBL-PE) in the community, potentially contributing to the neonatal mortality, is a public health concern. Data regarding the acquisition of ESBL-PE during the neonatal period are scarce. The routes of transmission are not well defined and particularly the possible key role played by pregnant women. This study aimed to understand the neonatal acquisition of ESBL-PE in the community in Madagascar...
2018: PloS One
Kovy Arteaga-Livias, Angela Bonilla-Crispin, Vicky Panduro-Correa, Carlos Martínez-Enríquez, Bernardo Dámaso-Mata
Dengue is the disease transmitted by arthropods of major importance in public health; however its presence in the neonatal stage is poorly studied, with few cases described worldwide. We present the case report of a neonate who started illness at 12 days of age, characterized by fever and irritability. He was hospitalized for suspicion of neonatal sepsis; later he presented thrombocytopenia and due the antecedent of his mother with diagnosis of dengue after childbirth, dengue tests were obtained in the neonate, resulting positive, then support treatment and fluid treatment is performed, with subsequent recovery...
October 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Elisa Jiménez, Nicolás Valls, Patricio Astudillo, Cristian Valls, Gabriel Cavada, Alejandra Sandoval, Angélica Alegría, Gabriela Ortega, Daniela Núñez, Patricia Mena
BACKGROUND: Antibiotics (ATB) are drugs widely used in hospitalized newborns. The indiscriminate use of ATBs promote the rise of resistant bacteria to the most commonly indicated antimicrobials. In addition, ATB prescription presents associations to morbidity, such as bronchopulmonary dysplasia, necrotizing enterocolitis, late sepsis and even death. All of the above leads to an increase in health care costs. AIM: To record and to evaluate trends of antibiotic use over time in hospitalized NB in the Neonatology Unit at Dr...
December 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Thomas A Hooven, Tara M Randis, Richard A Polin
Asymptomatic term and late-preterm newborns with risk factors for early onset sepsis commonly undergo laboratory evaluation and receive empiric antibiotic therapy. Some have challenged the rationale for current "rule-out sepsis" practices, arguing that they lead to unnecessary overtreatment and healthcare costs. A series of recent clinical studies has explored scheduled serial observations as an alternative to laboratory testing and empiric antibiotics for asymptomatic newborns with historical risk factors for sepsis...
February 26, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Ann L Jefferies
Early-onset neonatal bacterial sepsis (EOS) is sepsis occurring within the first 7 days of life. This statement provides updated recommendations for the care of term (≥37 weeks' gestational age) newborns at risk of EOS, during the first 24 hours of life. Maternal Group B streptococcus (GBS) colonization in the current pregnancy, GBS bacteriuria, a previous infant with invasive GBS disease, prolonged rupture of membranes (≥18 hours) and maternal fever (temperature ≥38°C) are the factors most commonly associated with EOS...
July 2017: Paediatrics & Child Health
Anders Brunse, Päivi Worsøe, Susanne Elisabeth Pors, Kerstin Skovgaard, Per Torp Sangild
Preterm infants have increased risk of neonatal sepsis, potentially inducing brain injury, and they may benefit from early initiation of enteral milk feeding. Using preterm pigs as models, we hypothesized that early provision of bovine colostrum to parentally nourished newborns protects against sepsis and neuroinflammation during bloodstream infection. Preterm newborn pigs were administered 10 CFU/kg of intra-arterial Staphylococcus epidermidis (SE, an opportunistic pathogen often causing sepsis in preterm infants), followed by administration of total parenteral nutrition (TPN, SE + TPN, n = 15) or oral provision of bovine colostrum with supplementary parenteral nutrition (SE + COL, n = 14), and compared with uninfected, TPN-nourished controls (CON + TPN, n = 11)...
February 21, 2018: Shock
Gabriella Comunián-Carrasco, Guiomar E Peña-Martí, Arturo J Martí-Carvajal
BACKGROUND: Gonorrhoea is a sexually transmitted infection that is caused by Neisseria gonorrhoeae, and is a major public health challenge today. N gonorrhoeae can be transmitted from the mother's genital tract to the newborn during birth, and can cause gonococcal ophthalmia neonatorum as well as systemic neonatal infections. It can also cause endometritis and pelvic sepsis in the mother. This review updates and replaces an earlier Cochrane Review on antibiotics for treating this infectious condition...
February 21, 2018: Cochrane Database of Systematic Reviews
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