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Early onset sepsis

Olivia Oria de Rueda Salguero, José Beceiro Mosquera, Marta Barrionuevo González, María Jesús Ripalda Crespo, Cristina Olivas López de Soria
INTRODUCTION: Early diagnosis of early-onset neonatal sepsis (EONS) is essential to reduce morbidity and mortality. Procalcitonin (PCT) in cord blood could provide a diagnosis of infected patients from birth. OBJECTIVE: To study the usefulness and safety of a procedure for the evaluation of newborns at risk of EONS, based on the determination of PCT in cord blood. PATIENTS AND METHODS: Neonates with infectious risk factors, born in our hospital from October 2013 to January 2015 were included...
October 14, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Adam W Bartlett, Ben Smith, C R Robert George, Brendan McMullan, Alison Kesson, Monica M Lahra, Dip Paed, Pamela Palasanthiran
BACKGROUND: Group B Streptococcus (GBS) is a recognized cause of sepsis and meningitis, particularly in infants. Early onset (<7 days) GBS disease has been well characterized, whereas the epidemiology of late onset disease (LOD, 7-89 days) and very late onset disease (VLOD, ≥90 days) is less well understood. The aims of this study were to assess risk factors, presentation, management, and outcome for GBS LOD and VLOD. METHODS: Microbiology laboratory databases and hospital diagnostic coding for Sydney Children's Hospital and the Children's Hospital at Westmead were investigated for patients ≥ 7 days of age diagnosed with GBS bloodstream infection or meningitis from 1st January 2000 to 31st December 2014 (15 years)...
October 3, 2016: Pediatric Infectious Disease Journal
Vanessa Poliquin, Elissa Cohen, Philippe Guillaume Poliquin, Carol Schneider, Savas Menticoglou
OBJECTIVE: We reviewed cases of group B Streptococcus (GBS) sepsis in term infants at our institution to identify areas for potential prevention. METHODS: We identified cases by searching our institution's microbiology databases for all positive GBS blood and cerebrospinal fluid cultures taken from infants between 2008 and 2013. Patients were included if the timing of the positive culture met the criteria for early-onset GBS disease (age 7 days or under). Charts that met inclusion criteria were abstracted for details related to antepartum screening, intrapartum care, and postpartum outcome...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
M Hückstädt, G O Hofmann, T Mendel, R Stuttmann, P Hilbert-Carius
BACKGROUND: Sepsis and septic shock are major contributors to morbidity and mortality in intensive care patients. Early identification and adequate therapy are of utmost importance to reduce the still high mortality in patients with severe sepsis. Many of the pathophysiologic changes are nonspecific. Thus, a combination of symptoms and laboratory results are necessary to confirm the diagnosis. Impairment of the Horovitz index is identified as being a primal prognostic criterion for early diagnosis in serious progression of sepsis, after exclusion of a few differential diagnoses...
October 5, 2016: Der Anaesthesist
J I González-Muñoz, G Franch-Arcas, M Angoso-Clavijo, M Sánchez-Hernández, A García-Plaza, M Caraballo-Angeli, L Muñoz-Bellvís
PURPOSE: Age and comorbidities increase the surgical risk for patients with acute cholecystitis and impact on the initial treatment selection. The aim of this article is the implementation of objective risk criteria that may be used to select the most appropriate treatment. METHODS: We carried out a prospective cohort study of all patients who were admitted to the hospital with a diagnosis of acute cholecystitis during 2014. They were initially allocated to three different treatment groups according to cholecystitis grade, number of days from clinical onset, and surgical risk scores as follows: immediate surgery by sepsis (EmergS), early surgery (EarlyS), or medical treatment group (MedT)...
October 4, 2016: Langenbeck's Archives of Surgery
Neslihan Edeer Karaca, Guzide Aksu, Ezgi Ulusoy, Serap Aksoylar, Salih Gozmen, Ferah Genel, Sanem Akarcan, Nesrin Gulez, Tatjana Hirschmugl, Savas Kansoy, Kaan Boztug, Necil Kutukculer
Alterations of immune homeostasis in the gut may result in development of inflammatory bowel disease. A five-month-old girl was referred for recurrent respiratory and genitourinary tract infections, sepsis in neonatal period, chronic diarrhea, perianal abscess, rectovaginal fistula, and hyperemic skin lesions. She was born to second-degree consanguineous, healthy parents. Her elder siblings were lost at 4 months of age due to sepsis and 1 year of age due to inflammatory bowel disease, respectively. Absolute neutrophil and lymphocyte counts, immunoglobulin levels, and lymphocyte subsets were normal ruling out severe congenital neutropenia and classic severe combined immunodeficiencies...
2016: Case Reports in Immunology
G S Kew, J Cho, A Lateef
We describe a gravid 37-year-old Chinese lady with known triple positive primary antiphospholipid syndrome with previous recurrent deep vein thrombosis and early spontaneous miscarriages. She was managed with low-molecular weight heparin, aspirin, hydroxychloroquine, prednisolone and monthly intravenous immunoglobulin.She presented with recurrent per-vaginal bleeding at 22 weeks of gestation and was found to have abruptio placentae. Anti-coagulation was held off. She subsequently delivered a stillborn at 24 weeks and anti-coagulation was restarted...
October 1, 2016: Lupus
Thomas Desautels, Jacob Calvert, Jana Hoffman, Melissa Jay, Yaniv Kerem, Lisa Shieh, David Shimabukuro, Uli Chettipally, Mitchell D Feldman, Chris Barton, David J Wales, Ritankar Das
BACKGROUND: Sepsis is one of the leading causes of mortality in hospitalized patients. Despite this fact, a reliable means of predicting sepsis onset remains elusive. Early and accurate sepsis onset predictions could allow more aggressive and targeted therapy while maintaining antimicrobial stewardship. Existing detection methods suffer from low performance and often require time-consuming laboratory test results. OBJECTIVE: To study and validate a sepsis prediction method, InSight, for the new Sepsis-3 definitions in retrospective data, make predictions using a minimal set of variables from within the electronic health record data, compare the performance of this approach with existing scoring systems, and investigate the effects of data sparsity on InSight performance...
September 30, 2016: JMIR Medical Informatics
Anwar A Rass, Mohamed A Talat, Mohamed A Arafa, Hosam F El-Saadany, Ezzat K Amin, Mohamed Mohamed Abdelsalam, Mona A Mansour, Naglaa A Khalifa, Lamiaa Mahmoud Kamel
Introduction. Early diagnosis and treatment of neonatal sepsis may help decrease neonatal mortality. Aim of the Study. To evaluate the role of pancreatic stone protein as a marker for early onset neonatal sepsis. Methods. A hospital-based prospective study was conducted on 104 (52 uninfected and 52 infected neonates) admitted to the Neonatal Intensive Care Unit (NICU) of Zagazig University hospitals during the period from April 2014 to April 2015. All newborns were subjected to full history taking, careful neonatal assessment, blood, C-reactive protein (CRP), and serum pancreatic stone protein...
2016: BioMed Research International
Mirza Sultan Ahmad, Naila Ali, Nazia Mehboob, Ramlah Mehmood, Mubashra Ahmad, Abdul Wahid
OBJECTIVE: To ascertain the prevalence of hyperthermia and different categories of hypothermia among the cases of probable and culture-proven neonatal sepsis, and to evaluate association of mortality rate with axillary temperature at admission. METHODS: This analytical study was conducted at Fazl-e-Omar Hospital, Rabwah, Pakistan, from January to December 2013, and comprised all cases of culture-proven and probable neonatal sepsis admitted in the neonatal intensive-care unit of the hospital...
October 2016: JPMA. the Journal of the Pakistan Medical Association
Sormeh Salehian, Abhinav Rastogi, Olivier Ghez, Margarita Burmester
Group B streptococcus (GBS) is recognised as one of the leading organisms in early-onset neonatal sepsis but is also a cause of late-onset GBS septicaemia, meningitis and rarely, infective endocarditis (IE). We report a case of a healthy term neonate who developed GBS septicaemia and meningitis having presented with parental concern and poor feeding. Subsequent identification and treatment of GBS resulted in the requirement for long-line intravascular access in order to administer antibiotic therapy. One week later, after repeated parental concern and symptoms of shortness of breath, the neonate presented to Accident and Emergency and subsequently a Paediatric Cardiorespiratory Intensive Care Unit where emergency resuscitation procedures were required and diagnosis of severe IE affecting the mitral valve was made...
2016: BMJ Case Reports
Chiara Matani, Michele Trezzi, Alice Matteini, Carlotta Catalani, Daniela Messeri, Corrado Catalani
Intrapartum antibiotic prophylaxis (IAP) reduces both the vertical transmission of Streptococcus agalactiae or Group B Streptococcus (GBS) and the early onset of neonatal sepsis. However, existing guidelines do not recommend that antimicrobial susceptibility testing (AST) be routinely performed. Penicillin or ampicillin are indicated as first-choice antibiotics, cefazolin being an alternative in the case of history of mild allergic reactions, and vancomycin or clindamycin an alternative in the event of severe reactions...
September 1, 2016: Le Infezioni in Medicina
Yu He, Wei Xia Du, Hong Yan Jiang, Qing Ai, Jinxing Feng, Zhengqiu Liu, Jia Lin Yu
BACKGROUND: Early onset sepsis (EOS) remains a major cause of mortality and morbidity in neonates, and traditional clinical markers effective for adults are less effective in these patients. This study aimed to assess the value of individual plasma biomarkers as well as biomarker combinations for predicting EOS in neonates. METHODS: This prospective study included 151 neonates with suspected EOS. Plasma levels of interleukin (IL)-27, IL-6, IL-8, tumor necrosis factor (TNF)-α, heat shock protein (HSP) 70, macrophage inflammatory protein (MIP)-1α, MIP-1β, granzyme B, and matrix metalloproteinase (MMP)-8 were measured through multiplex cytokine profiling and assessed along with C-reactive protein (CRP) and procalcitonin (PCT)...
September 19, 2016: Shock
(no author information available yet)
BACKGROUND: Sepsis is one of the most common causes of neonatal deaths globally. Most sepsis-related deaths occur in low-income and middle-income countries, where the epidemiology of neonatal sepsis remains poorly understood. Most of these countries lack proper surveillance networks, hampering accurate assessment of the burden of sepsis, implementation of preventive measures, and investment in research. We report results of neonates born in hospital from a multicentre collaboration on neonatal sepsis...
October 2016: Lancet Global Health
Wei-Xia Du, Yu He, Hong-Yan Jiang, Qing Ai, Jia-Lin Yu
BACKGROUND: Early onset sepsis (EOS) remains a major cause of morbidity and mortality in newborns; however, current diagnostic tools are inadequate. We evaluated the accuracy of a novel cytokine, interleukin (IL)-35, for the diagnosis of EOS in comparison with other infection markers. METHODS: One hundred fifty-seven neonates with suspected sepsis in the first 3days of life were enrolled in this perspective study. All enrolled patients were divided into infected group and unlikely infected group according to clinical data...
November 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Zbynek Stranak, Jaroslav Feyereisl, Peter Korcek, Simona Feyereislova, Ladislav Krofta
AIMS: To analyze the relationship between maternal, cord blood and neonatal procalcitonin (PCT) levels in preterm deliveries with and without histologically proven chorioamnionitis (HCA). METHODS: 91 mother-infant pairs from 24+0 to 33+0 gestational weeks were analyzed. Procalcitonin was measured in all mothers within 24 hours before and subsequently in cord blood and in neonates within the first two hours after delivery. PCT levels were analysed in relationship to HCA and clinical outcome...
September 5, 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Andrew K Ewer
The detection of newborn babies with potentially life-threatening, critical congenital heart defects (CCHDs) before they collapse or expire remains an important clinical challenge. The absence of physical signs and the difficulty assessing mild cyanosis means that the newborn baby check misses up to a third of babies. Fetal anomaly ultrasound scanning identifies an increasing proportion, but this screen is operator-dependent and therefore highly variable; although some units report very high detection rates, overall most babies with CCHD are still missed...
September 2016: American Journal of Perinatology
Marco H Schulze, Fabian M Völker, Raimond Lugert, Paul Cooper, Kai Hasenclever, Uwe Groß, Herbert Pfister, Steffi Silling
Data about the prevalence of human papillomaviruses (HPV) in African women with normal and abnormal cervical cytology are still scarce. Current HPV vaccines contain HPV types, which mainly represent the HPV epidemiology of industrial countries. As further developments of HPV vaccines are going on, it is necessary to regard regional differences in HPV type prevalence to ensure optimal protection by the vaccine. Vaginal swabs of Ghanaian pregnant women, routinely collected before delivery to rule out bacterial infections causing early onset sepsis, were screened for 12 high-risk (HR), 13 probably/possibly (pHR), and 18 low-risk (LR) HPV types...
September 6, 2016: Medical Microbiology and Immunology
A Y Mushkin, E Y Malyarova, V A Evseev, P K Yablonskii
DESIGN: Case report. INTRODUCTION: The combination of severe post-infectious kyphosis and diaphragm relaxation is extremely rare in patient early than 1 year old. Its no publications concerning their simultaneous surgical treatment. CASE DESCRIPTION: 7-Month-old girl had simultaneous spinal reconstruction with anterior and posterior instrumentation and plastic of diaphragm because of sequelae of non-granulenatous spondylitis complicated by severe kyphosis (54°) and diaphragm relaxation...
2016: Neurologia i Neurochirurgia Polska
Hideo Koh, Mizuki Aimoto, Akio Matsuhisa, Shin-Ichi Inoue, Takako Katayama, Hiroshi Okamura, Takuro Yoshimura, Shiro Koh, Satoru Nanno, Mitsutaka Nishimoto, Yasuhiro Nakashima, Asao Hirose, Mika Nakamae, Takahiko Nakane, Masayuki Hino, Hirohisa Nakamae
BACKGROUND: A new 23S ribosomal RNA genes-targeted in situ hybridization (ISH) probe to detect global bacterial genomic DNA (59 species from 35 genera; referred to as the GB probe) phagocytized in leukocytes was recently developed. This method provided early and direct evidence of bacterial infection with high sensitivity and specificity in spontaneous bacterial peritonitis ascites. However, the utility of this method in febrile neutropenia (FN) is unknown. METHODS: We prospectively evaluated the utility of the ISH approach using the GB probe and previously reported probes in patients with neutropenia and fever undergoing chemotherapy at our institution between June 2011 and July 2013...
October 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
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