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Early onset sepsis

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https://www.readbyqxmd.com/read/28241253/a-quantitative-risk-based-approach-to-the-management-of-neonatal-early-onset-sepsis
#1
Michael W Kuzniewicz, Karen M Puopolo, Allen Fischer, Eileen M Walsh, Sherian Li, Thomas B Newman, Patricia Kipnis, Gabriel J Escobar
Importance: Current algorithms for management of neonatal early-onset sepsis (EOS) result in medical intervention for large numbers of uninfected infants. We developed multivariable prediction models for estimating the risk of EOS among late preterm and term infants based on objective data available at birth and the newborn's clinical status. Objectives: To examine the effect of neonatal EOS risk prediction models on sepsis evaluations and antibiotic use and assess their safety in a large integrated health care system...
February 20, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28237500/prospects-for-preventing-infant-invasive-gbs-disease-through-maternal-vaccination
#2
Shabir A Madhi, Ziyaad Dangor
Group B streptococcus (GBS) is a leading cause of neonatal sepsis, with the highest incidence (1.3 per 1000 live births) reported from Africa. Although the incidence of invasive GBS disease is reportedly low in South Asia, there is disconnect between prevalence of maternal recto-vaginal colonization and the incidence of early-onset disease (EOD). This is possibly due to case-ascertainment biases that omit investigation of newborns dying on day-0 of life, which accounts for >90% of EOD. Furthermore, GBS is associated with approximately 15% of all infection related stillbirths...
February 22, 2017: Vaccine
https://www.readbyqxmd.com/read/28221298/mr-proadm-a-new-biomarker-for-early-diagnosis-of-sepsis-in-burned-patients
#3
Jochen Gille, Hanfried Ostermann, Adrian Dragu, Armin Sablotzki
Mid-regional pro-adrenomedullin (MR-proADM) has been used as a marker of sepsis, but its dynamics and role in a burn injury setting has not been tested. In a prospective observational study, we included 42 consecutive patients with >15% TBSA. Daily blood specimens collected during the initial 20 days of treatment were submitted for laboratory analysis of MR-proADM and procalcitonin (PCT) via immunoluminometric sandwich assay (Kryptor, BRAHMS, Berlin, Germany). In patients with an absence of sepsis, an initial increase in MR-proADM and PCT levels was noted post burn injury, peaking on the second day post admission and thereafter demonstrated a continued decline in MR-proADM and PCT levels...
February 15, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28216060/incidence-of-fever-in-labor-and-risk-of-neonatal-sepsis
#4
Craig V Towers, Angela Yates, Nikki Zite, Casey Smith, Lindsey Chernicky, Bobby Howard
BACKGROUND: The current recommendation regarding the management of a term newborn delivered of a mother with an intrapartum fever or a diagnosis of clinical chorioamnionitis is that the neonate should have baseline laboratory work drawn along with blood cultures and be universally treated with antibiotics until culture results return. These guidelines report that the rate of intrapartum fever is about 3%; however, a few large studies suggest that the rate is higher at about 7%. OBJECTIVE: To prospectively evaluate the rate of fever during labor in a large number of deliveries and determine the rate of early onset neonatal sepsis in newborns delivered from mothers with an intrapartum fever compared with the newborns that delivered from mothers that did not have an intrapartum fever...
February 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28211788/hemolytic-uremic-syndrome-complicated-by-clostridium-septicum-bacteremia-and-new-onset-type-1-diabetes-mellitus-report-of-a-case%C3%A2
#5
Anna C Iddings, Asha N Shenoi, Alba Morales Pozzo, Stefan G Kiessling
We report the unusual case of a 5-year-old male hospitalized for management of diabetic ketoacidosis (DKA) and new-onset type 1 diabetes mellitus (T1DM) who developed acute renal injury secondary to hemolytic uremic syndrome (HUS). He was diagnosed with Shiga toxin-producing entero-hemorrhagic Escherichia coli (EHEC) 0157:H7-positive HUS 48 hours after being diagnosed with new-onset T1DM/DKA. His hospital course was complicated by Clostridium septicum sepsis with colonic perforation. This patient's diagnosis of new-onset T1DM just prior to HUS is novel...
February 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28211488/differences-in-the-clinical-characteristics-of-early-and-late-onset-necrotizing-enterocolitis-in-full-term-infants-a-retrospective-case-control-study
#6
Qiu-Yu Li, Yao An, Li Liu, Xue-Qiu Wang, Shi Chen, Zheng-Li Wang, Lu-Quan Li
Information regarding the influence of age at onset on prognosis in full-term infants with necrotizing enterocolitis (NEC) is limited, and identifying differences between the clinical characteristics of early-onset NEC (EO-NEC) and late-onset NEC (LO-NEC) may be helpful in the determination of effective management strategies. In the present study, the medical records of 253 full-term infants with NEC were reviewed, and the clinical characteristics of the EO-NEC group (n = 150) and the LO-NEC group (n = 103) were compared...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28202033/use-of-stepwise-lactate-kinetics-oriented-hemodynamic-therapy-could-improve-the-clinical-outcomes-of-patients-with-sepsis-associated-hyperlactatemia
#7
Xiang Zhou, Dawei Liu, Longxiang Su, Bo Yao, Yun Long, Xiaoting Wang, Wenzhao Chai, Na Cui, Hao Wang, Xi Rui
BACKGROUND: Setting lactate kinetics at >30% might improve the clinical outcomes of patients with sepsis-associated hyperlactatemia. The aim of this study was to explore the outcome benefits of stepwise lactate kinetics vs central venous oxygen saturation (ScvO2)-oriented hemodynamic therapy at 6 h as the protocol goal during early resuscitation. METHODS: The relevant parameters and adverse events after different targets in 360 randomly assigned patients with sepsis-associated hyperlactatemia were recorded and compared...
February 16, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28196284/early-onset-neonatal-sepsis-is-associated-with-a-high-heart-rate-during-automatically-selected-stationary-periods
#8
Nga Nguyen, Laurent Vandenbroucke, Alfredo Hernández, Tu Pham, Alain Beuchée, Patrick Pladys
AIM: This study examined the heart rate variability characteristics associated with early onset neonatal sepsis in a prospective, observational controlled study. METHODS: Eligible patients were full-term neonates hospitalised with clinical signs that suggested early onset sepsis and a C reactive protein of > 10 mg/L. Sepsis was considered proven in cases of symptomatic septicaemia, meningitis, pneumonia or enterocolitis. Heart rate variability parameters (n=16) were assessed from five, 15 and 30 minutes stationary sequences automatically selected from electrocardiographic recordings performed at admission and compared with a control group using the U-test with post-hoc Benjamini-Yekutieli correction...
February 14, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28187059/clinical-and-microbiologic-characteristics-of-early-onset-sepsis-among-vlbw-infants-opportunities-for-antibiotic-stewardship
#9
Sagori Mukhopadhyay, Karen M Puopolo
BACKGROUND: Most very-low birth weight (birth weight <1500 grams, VLBW) infants receive empiric antibiotics for risk of early-onset sepsis (EOS). The objective of this study was to determine the characteristics of VLBW infants with culture-confirmed EOS at a single center during 25 years, to identify opportunities for antibiotic stewardship. METHODS: Retrospective cohort study including VLBW infants admitted from 1990-2015. EOS was defined as isolation of a pathogen in blood or cerebrospinal fluid culture obtained < 72 hours of age...
February 9, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28179905/plasma-levels-of-macrophage-migration-inhibitory-factor-and-d-dopachrome-tautomerase-show-a-highly-specific-profile-in-early-life
#10
Thierry Roger, Luregn J Schlapbach, Anina Schneider, Manuela Weier, Sven Wellmann, Patrick Marquis, David Vermijlen, Fred C G J Sweep, Lin Leng, Richard Bucala, Thierry Calandra, Eric Giannoni
Macrophage migration inhibitory factor (MIF) is a pleiotropic, constitutively expressed, pro-inflammatory cytokine and an important regulator of immune responses. d-dopachrome tautomerase (DDT), a newly described member of the MIF protein superfamily, shares sequence homology and biological activities with MIF. We recently reported that high expression levels of MIF sustain innate immune responses in newborns. Here, we elected to further characterize age-dependent MIF expression and to define whether DDT shares a similar expression profile with MIF...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28179485/variation-in-sepsis-evaluation-across-a-national-network-of-nurseries
#11
Sagori Mukhopadhyay, James A Taylor, Isabelle Von Kohorn, Valerie Flaherman, Anthony E Burgos, Carrie A Phillipi, Nui Dhepyasuwan, Elizabeth King, Miren Dhudasia, Karen M Puopolo
BACKGROUND AND OBJECTIVES: The extent to which clinicians use currently available guidelines for early-onset sepsis (EOS) screening has not been described. The Better Outcomes through Research for Newborns network represents 97 nurseries in 34 states across the United States. The objective of this study was to describe EOS risk management strategies across a national sample of newborn nurseries. METHODS: A Web-based survey was sent to each Better Outcomes through Research for Newborns network nursery site representative...
February 8, 2017: Pediatrics
https://www.readbyqxmd.com/read/28179483/the-well-appearing-newborn-at-risk-for-early-onset-sepsis-we-can-do-better
#12
James J Cummings
No abstract text is available yet for this article.
February 8, 2017: Pediatrics
https://www.readbyqxmd.com/read/28155332/reducing-antibiotic-exposure-in-suspected-neonatal-sepsis
#13
Christopher Henry Grant, Andrew Arnott, Tim Brook, Alice Horne, William Hurst, Sarah Kelly, Christina Lang, Madeleine Payne, Hannah Pert, Sarah Sparrow, Pakaye Anne Dokubo, Natalie Bee, Ruth Gibbs, Julie-Clare Becher
Prolonged antibiotic therapy is associated with antimicrobial resistance and increased mortality in preterm infants. We evaluated the impact of an automatic stop order (ASO) and C-reactive protein (CRP) on the duration of antibiotics and level of intervention in infants screened for early-onset sepsis who had negative cultures. We introduced an ASO for low-risk infants, then, consequently, for all infants treated for suspected sepsis. We subsequently introduced a single CRP measurement at 36 hours. Between 2011 and 2014, 4 time periods were studied, at baseline and after each intervention...
January 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28134708/chorioamnionitis-time-for-a-new-approach
#14
Tara M Randis, Richard A Polin, George Saade
PURPOSE OF REVIEW: The association between maternal chorioamnionitis and early-onset sepsis in the newborn has long been recognized, and established guidelines recommend treating all exposed infants with broad-spectrum antibiotics until infection can be ruled out. However, recent data suggest that close observation of well appearing term and late-preterm newborns may be a preferable alternative. The present review addresses the evidence in favor of newly proposed changes to the diagnosis and management of women and newborns following a maternal diagnosis of chorioamnionitis...
January 27, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28128518/maternal-and-neonatal-outcomes-in-women-with-severe-early-onset-pre-eclampsia-before-26-weeks-of-gestation-a-case-series
#15
M F van Oostwaard, L van Eerden, M W de Laat, J J Duvekot, Jjhm Erwich, Kwm Bloemenkamp, A C Bolte, Jpf Bosma, S V Koenen, R F Kornelisse, B Rethans, P van Runnard Heimel, Hcj Scheepers, W Ganzevoort, Bwj Mol, C J de Groot, Ipm Gaugler-Senden
OBJECTIVE: To describe the maternal and neonatal outcomes and prolongation of pregnancies with severe early onset pre-eclampsia before 26 weeks of gestation. DESIGN: Nationwide case series. SETTING: All Dutch tertiary perinatal care centres. POPULATION: All women diagnosed with severe pre-eclampsia who delivered between 22 and 26 weeks of gestation in a tertiary perinatal care centre in the Netherlands, between 2008 and 2014...
January 27, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28125181/neonatal-bacteraemia-among-112-360-live-births
#16
D Huggard, R Drew, N McCallion
Our aims were to determine the incidence of bacteraemia in a cohort of neonatal patients over a 14 year period, to describe the organisms involved, and to establish the rates of sepsis with regard to both early onset sepsis (EOS) and late onset sepsis (LOS). Lastly, we investigated the trends of neonatal sepsis, to determine whether changes in clinical practice influenced the rate of blood culture positivity. With regards to EOS, GBS was the predominant pathogen, followed by E.coli, CoNS, and S. aureus . The overall mean EO rate per 1000 live births (LBs) was 1...
October 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28101605/surviving-sepsis-campaign-international-guidelines-for-management-of-sepsis-and-septic-shock-2016
#17
Andrew Rhodes, Laura E Evans, Waleed Alhazzani, Mitchell M Levy, Massimo Antonelli, Ricard Ferrer, Anand Kumar, Jonathan E Sevransky, Charles L Sprung, Mark E Nunnally, Bram Rochwerg, Gordon D Rubenfeld, Derek C Angus, Djillali Annane, Richard J Beale, Geoffrey J Bellinghan, Gordon R Bernard, Jean-Daniel Chiche, Craig Coopersmith, Daniel P De Backer, Craig J French, Seitaro Fujishima, Herwig Gerlach, Jorge Luis Hidalgo, Steven M Hollenberg, Alan E Jones, Dilip R Karnad, Ruth M Kleinpell, Younsuk Koh, Thiago Costa Lisboa, Flavia R Machado, John J Marini, John C Marshall, John E Mazuski, Lauralyn A McIntyre, Anthony S McLean, Sangeeta Mehta, Rui P Moreno, John Myburgh, Paolo Navalesi, Osamu Nishida, Tiffany M Osborn, Anders Perner, Colleen M Plunkett, Marco Ranieri, Christa A Schorr, Maureen A Seckel, Christopher W Seymour, Lisa Shieh, Khalid A Shukri, Steven Q Simpson, Mervyn Singer, B Taylor Thompson, Sean R Townsend, Thomas Van der Poll, Jean-Louis Vincent, W Joost Wiersinga, Janice L Zimmerman, R Phillip Dellinger
OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015...
March 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28100323/-high-risk-factors-and-clinical-characteristics-of-massive-pulmonary-hemorrhage-in-infants-with-extremely-low-birth-weight
#18
Dan Chen, Meng Wang, Xin Wang, Xue-Wei Ding, Rui-Hua Ba, Jian Mao
OBJECTIVE: To explore the high-risk factors and analyze the clinical characteristics of massive pulmonary hemorrhage (MPH) in infants with extremely low birth weight (ELBW). METHODS: Two hundred and eleven ELBW infants were included in this study. Thirty-five ELBW infants who were diagnosed with MPH were labelled as the MPH group, and 176 ELBW infants without pulmonary hemorrhage were labelled as the control group. The differences in clinical characteristics, mortality rate, and incidence of complications between the two groups were analysed...
January 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28098591/surviving-sepsis-campaign-international-guidelines-for-management-of-sepsis-and-septic-shock-2016
#19
Andrew Rhodes, Laura E Evans, Waleed Alhazzani, Mitchell M Levy, Massimo Antonelli, Ricard Ferrer, Anand Kumar, Jonathan E Sevransky, Charles L Sprung, Mark E Nunnally, Bram Rochwerg, Gordon D Rubenfeld, Derek C Angus, Djillali Annane, Richard J Beale, Geoffrey J Bellinghan, Gordon R Bernard, Jean-Daniel Chiche, Craig Coopersmith, Daniel P De Backer, Craig J French, Seitaro Fujishima, Herwig Gerlach, Jorge Luis Hidalgo, Steven M Hollenberg, Alan E Jones, Dilip R Karnad, Ruth M Kleinpell, Younsuck Koh, Thiago Costa Lisboa, Flavia R Machado, John J Marini, John C Marshall, John E Mazuski, Lauralyn A McIntyre, Anthony S McLean, Sangeeta Mehta, Rui P Moreno, John Myburgh, Paolo Navalesi, Osamu Nishida, Tiffany M Osborn, Anders Perner, Colleen M Plunkett, Marco Ranieri, Christa A Schorr, Maureen A Seckel, Christopher W Seymour, Lisa Shieh, Khalid A Shukri, Steven Q Simpson, Mervyn Singer, B Taylor Thompson, Sean R Townsend, Thomas Van der Poll, Jean-Louis Vincent, W Joost Wiersinga, Janice L Zimmerman, R Phillip Dellinger
OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012." DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015...
March 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28093452/a-time-to-save
#20
Carol J Baker
Group B Streptococcus (GBS), characterized by Lancefield in 1933, was not recognized as a human pathogen until the early 1970s when it emerged and replaced Escherichia coli as the most common cause of sepsis and meningitis among neonates and young infants. This article briefly gives a personnel account of the discovery of clinical syndromes of GBS distinguished by age at onset, vertical mode of transmission for early-onset disease, meningeal tropism for GBS capsular (CPS) type III strains, and protective CPS epitopes...
January 16, 2017: Journal of the Pediatric Infectious Diseases Society
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