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infant sepsis

Mona Noureldein, Roxana Mardare, Jack Pickard, Hoi Lun Shing, Michael Eisenhut
BACKGROUND: It has been estimated that paediatric meningitis without elevated CSF white cell count (pleocytosis) accounts for 0.5-12% of all cases of bacterial meningitis. CSF protein and glucose measurements are therefore essential in management but may be neglected in clinical practice. In order to improve recognition of bacterial meningitis in neonates and to enable adequate management and audit, we investigated whether a systemic inflammatory response in the absence of meningitis is associated with elevated CSF protein and reduced CSF glucose levels...
March 14, 2018: Fluids and Barriers of the CNS
Joseph B Cantey, Kelsey R Anderson, Ram R Kalagiri, Lea H Mallett
BACKGROUND: Coagulase-negative staphylococci (CoNS) are the most common cause of late-onset sepsis in the neonatal intensive care unit (NICU) and usually require vancomycin treatment. Our objective was to determine whether CoNS are associated with neonatal morbidity and mortality. METHODS: This was a retrospective cohort study of very-low-birth-weight (VLBW, ≤ 1500 g) infants from 1989 to 2015. Exclusion criteria were major congenital anomaly or death within 72 h...
March 13, 2018: World Journal of Pediatrics: WJP
Annika Mutanen, Agostino Pierro, Augusto Zani
Necrotizing enterocolitis (NEC) is a devastating condition that mainly affects premature infants. Advanced cases of NEC require surgical treatment, which in up to 70% of infants is associated with significant perioperative morbidity including anastomosis- or enterostomy-related complications, sepsis, peritonitis, and wound infections. Moreover, the perioperative complications may compromise the long-term gastrointestinal and neurodevelopmental outcome of patients requiring surgery for NEC.
March 13, 2018: European Journal of Pediatric Surgery
Emma de Jong, David G Hancock, Christine Wells, Peter Richmond, Karen Simmer, David Burgner, Tobias Strunk, Andrew J Currie
Preterm infants are uniquely susceptible to late-onset sepsis that is frequently caused by the skin commensal Staphylococcus epidermidis. Innate immune responses, particularly from monocytes, are a key protective mechanism. Impaired cytokine production by preterm infant monocytes is well described, but few studies have comprehensively assessed the corresponding monocyte transcriptional response. Innate immune responses in preterm infants may be modulated by inflammation such as prenatal exposure to histologic chorioamnionitis which complicates 40-70% of preterm pregnancies...
March 13, 2018: Immunology and Cell Biology
Yan-Ting Song, Yong-Qin Wang, Yue-Hua Zhao, Hai-Ling Zhu, Qian Liu, Xiao Zhang, Yi-Wen Gao, Wei-Ye Zhang, Yu-Tong Sang
OBJECTIVE: To study the risk factors for elevated serum total bile acid (TBA) in preterm infants. METHODS: A retrospective analysis was performed for the clinical data of 216 preterm infants who were admitted to the neonatal intensive care unit. According to the presence or absence of elevated TBA (TBA >24.8 μmol/L), the preterm infants were divided into elevated TBA group with 53 infants and non-elevated TBA group with 163 infants. A univariate analysis and an unconditional multivariate logistic regression analysis were used to investigate the risk factors for elevated TBA...
March 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Ariel A Salas, Peng Li, Kelli Parks, Charitharth V Lal, Camilia R Martin, Waldemar A Carlo
Background: Due to insufficient evidence, extremely preterm infants (≤28 wk of gestation) rarely receive early progressive feeding (small increments of feeding volumes between 1 and 4 d after birth). We hypothesized that early progressive feeding increases the number of full enteral feeding days in the first month after birth. Objective: The aim of this study was to determine the feasibility and efficacy of early progressive feeding in extremely preterm infants...
February 24, 2018: American Journal of Clinical Nutrition
Ryszard Lauterbach, Tobias Strunk, Sanjay Patole, Joanna Hurkała, Dorota Pawlik
Pentoxifylline (PTX) is a methylxanthine with immunomodulating properties that may be beneficial in neonatal sepsis.(1, 2) Mechanisms include inhibition of TLR-mediated inflammation, particularly in cord blood.(3, 4) PTX-related adverse events are rare, including in neonates. Systematic reviews suggest PTX is safe and potentially beneficial in this context.(5) Based on our clinical trials, we have been using PTX for the past 20 years in neonatal sepsis.(2) This article is protected by copyright. All rights reserved...
March 9, 2018: Acta Paediatrica
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
Ahmet Yagmur Bas, Nihal Demirel, Esin Koc, Dilek Ulubas Isik, İbrahim Murat Hirfanoglu, Turan Tunc
BACKGROUND: To evaluate the prevalence, risk factors and treatment of retinopathy of prematurity (ROP) in Turkey and to establish screening criteria for this condition. METHODS: A prospective cohort study (TR-ROP) was performed between 1 April 2016 and 30 April 2017 in 69 neonatal intensive care units (NICUs). Infants with a birth weight (BW)≤1500 g or gestational age (GA)≤32 weeks and those with a BW>1500 g or GA>32 weeks with an unstable clinical course were included in the study...
March 8, 2018: British Journal of Ophthalmology
Shunming Li, Guoming Wen, Xuelian Cao, Dan Guo, Zhenjiang Yao, Chuan'an Wu, Xiaohua Ye
BACKGROUND: Streptococcus agalactiae (GBS) is a leading cause of neonatal sepsis and meningitis in many countries. This study aimed to determine the molecular characteristics of GBS colonized in mothers and their infants so as to provide implication for vaccine strategies and confirm vertical transmission. METHODS: A prospective cohort study was conducted to recruit 1815 mother-neonate pairs. All GBS isolates from pregnant women and her infants were tested for serotypes, multilocus sequence types and virulence genes...
March 5, 2018: Vaccine
Dean B Percy, Candace Haddock, Vivian Ma, Amie Nowak, Julia Panczuk, Sonia Butterworth
OBJECTIVE: The purpose of this study was to describe outcomes and resource utilization in patients treated with twice-weekly silver impregnated (SI) nanocrystalline dressings for initial non-operative management of giant omphalocele (GO). METHODS: A retrospective review of patients with GO treated with SI dressings was undertaken. Clinical parameters, cost, and complications were recorded. RESULTS: Five patients with GO were treated with SI dressings between 2014 and 2016...
February 8, 2018: Journal of Pediatric Surgery
Arpitha Chiruvolu, Elise Elliott, Diana Rich, Genna Leal Stone, Huanying Qin, Robert W Inzer
BACKGROUND: In the range of timing suggested by American College of Obstetricians and Gynecologists 30 to 60 s, preterm infants may potentially derive more short and long-term benefits with delayed cord clamping (DCC) for at least 60 s. However, there are concerns with longer resuscitation delay in this vulnerable population. OBJECTIVE: To compare the clinical consequences of 45 versus 60 s delay in umbilical cord clamping in singleton infants born between 230/7 to 316/7 weeks gestation...
March 5, 2018: Early Human Development
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
Elita Jauneikaite, Georgia Kapatai, Frances Davies, Ioana Gozar, Juliana Coelho, Kathleen B Bamford, Benedetto Simone, Lipi Begum, Shannon Katiyo, Bharat Patel, Peter Hoffman, Theresa Lamagni, Eimear T Brannigan, Alison Holmes, Tokozani Kadhani, Tracey Galletly, Kate Martin, Hermione Lyall, Yimmy Chow, Sunit Godambe, Victoria Chalker, Shiranee Sriskandan
Background: Invasive Group B streptococcus (GBS) is a major cause of serious neonatal infection. Current strategies to reduce early onset GBS disease have no impact on late onset disease (LOD). Although GBS is a normal part of the enteric microbiota in healthy term infants, LOD cases arising in the neonatal intensive care unit setting raise questions about mode of acquisition. Methods: Enhanced surveillance for any case of late onset GBS sepsis admitted to a level 3, 24-bed neonatal intensive care unit over a 2 year period was instituted following a cluster of four cases...
March 2, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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
Mi Hye Bae, Hyun Ji Jang, Na Rae Lee, Young Mi Han, Shin Yun Byun, Kyung Hee Park
PURPOSE: Periventricular echogenicity (PVE) presents as diffuse echo dense lesions of the periventricular white matter on cranial ultrasonography. Beyond two weeks of life, it is considered as prolonged or persistent PVE. The aim of our study was to investigate the clinical characteristics of preterm infants with persistent PVE beyond 2 weeks after birth and to determine whether these infants had an adverse neurodevelopmental outcome. METHODS: The medical records of preterm infants who were born at < 34 weeks of gestation and admitted to Pusan National University Hospital between 2009 and 2014 were reviewed...
February 13, 2018: Pediatrics and Neonatology
Oscar Alonso Plaza, Freddy Moreno
Two cases of anatomical variations of the thymus are presented with respect to the anatomical relations with the left brachiocephalic vein and found during the necropsy process. Less than 2 days after birth with Noonan Syndrome, when the left brachiocephalic vein was scanning behind the upper thymus horns, there were other adjacent lesions consisting of three supernumerary spleens and three hepatic veins. The second case was an 8-year-old infant with child malpractice who died from urinary sepsis due to obstructive uropathy, in which case the upper lobes of the thymus were fused and formed a ring through which the left brachiocephalic vein passed...
April 2018: International Journal of Pediatric Otorhinolaryngology
Wael Seliem, Amira M Sultan
BACKGROUND: The aim of our study is to use presepsin level in umbilical cord blood as a predictor of EONS in preterm labor with premature rupture of membranes allowing rational use of antibiotics. METHODS: All preterm infants between 24+0 and 36+6 weeks of gestation born to pregnant women with a PROM were enrolled in our study. Blood samples were obtained from clamped umbilical cords after delivery of the neonates and prior to the delivery of the placenta for CRP and presepsin detection...
March 1, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
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