Performance of a Quantitative PCR-Based Assay and Beta-d-Glucan Detection for Diagnosis of Invasive Candidiasis in Very-Low-Birth-Weight Preterm Neonatal Patients (CANDINEO Study)

ABSTRACT An epidemiological, multicenter, noninterventional, observational case-control study was conducted to describe the performance of serum beta- d -glucan (BDG) and Candida PCR in blood, serum, and sterile samples for the diagnosis of invasive candidiasis (IC) in very-low-birth-weight (VLBW) preterm neonates and to compare these techniques with culture of samples from blood and other sterile sites. Seventeen centers participated in the study, and the number of episodes analyzed was 159. A total of 9 episodes of IC from 9 patients (7 confirmed and 2 probable) and 150 episodes of suspected sepsis from 117 controls were identified. The prevalence of IC was 5.7% (95% confidence interval [95% CI], 2.1 to 9.3). The mortality was significantly higher in episodes of IC (44.4%) than in the non-IC episodes (11.1%, P < 0.01). The sensitivity and specificity of the PCR performed on blood/serum samples were 87.5% and 81.6%, respectively. The sensitivity and specificity of the BDG results were lower (75.0% and 64.6%). For cases with negative culture results, the PCR and the BDG results were positive in 27 (17.4%) and 52 (33.5%) episodes, respectively. The presence of multiorgan failure, improvement with empirical antifungal therapy, thrombocytopenia, and Candida colonization were significantly associated ( P < 0.01) with PCR or BDG positivity regardless of the results of the cultures. Serum BDG analysis and Candida PCR could be used as complementary diagnostic techniques to detect IC in VLBW neonates.

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Selenium Supplementation for Prevention of Late-Onset Sepsis in Very Low Birth Weight Preterm Neonates

Journal of Tropical Pediatrics ◽

10.1093/tropej/fmv096 ◽

2016 ◽

Vol 62 (3) ◽

pp. 185-193 ◽

Cited By ~ 15

Author(s):

Rahul Aggarwal ◽

Geeta Gathwala ◽

Sudesh Yadav ◽

Pawan Kumar

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Late Onset ◽

Selenium Supplementation ◽

Preterm Neonates ◽

Late Onset Sepsis

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Probiotics to prevent necrotising enterocolitis and nosocomial infection in very low birth weight preterm infants

British Journal Of Nutrition ◽

10.1017/s0007114517000769 ◽

2017 ◽

Vol 117 (7) ◽

pp. 994-1000 ◽

Cited By ~ 8

Author(s):

J. Uberos ◽

E. Aguilera-Rodríguez ◽

A. Jerez-Calero ◽

M. Molina-Oya ◽

A. Molina-Carballo ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Late Onset ◽

Necrotising Enterocolitis ◽

Stage Ii ◽

Preterm Neonates ◽

Probiotic Supplementation ◽

Late Onset Sepsis ◽

Reduced Risk

AbstractThe aim of the study was to determine whether routine probiotic supplementation (RPS) with Lactobacillus rhamnosus GG (LGG) or Lactobacillus acidophilus +Lactobacillus bifidum is associated with reduced risk of necrotising enterocolitis (NEC)≥Stage II in preterm neonates born at ≤32 weeks’ gestation. We conducted a retrospective cohort study on the effect of probiotic supplementation in very low birth weight infants in our neonatal unit by comparing two periods: before and after supplementation. The incidence of NEC≥Stage II, late-onset sepsis and all-cause mortality was compared for an equal period ‘before’ (Period I) and ‘after’ (Period II) RPS with LGG or L. acidophillus+L. bifidum. Multivariate logistic regression analysis was conducted to adjust for relevant confounders. The study population was composed of 261 neonates (Period I v. II: 134 v. 127) with comparable gestation duration and birth weights. In <32 weeks, we observed a significant reduction in NEC≥Stage II (11·3 v. 4·8 %), late-onset sepsis (16 v. 10·5 %) and mortality (19·4 v. 2·3 %). The benefits in neonates aged ≤27 weeks did not reach statistical significance. RPS with LGG or L. acidophillus+L. bifidum is associated with a reduced risk of NEC≥Stage II, late-onset sepsis and mortality in preterm neonates born at ≤32 weeks’ gestation.

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Role of Sequential Functional Echocardiography in Predicting Clinically Apparent Patent Ductus Arteriosus in Preterm Very Low Birth Weight Newborns-An Observational Study

10.21203/rs.3.rs-125742/v1 ◽

2020 ◽

Author(s):

Anchala Bhardwaj ◽

ARVIND SAILI ◽

Dinesh Kumar Yadav ◽

Ajay Kumar

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Patent Ductus Arteriosus ◽

Left Atrial ◽

Very Low Birth Weight ◽

Ductus Arteriosus ◽

Preterm Neonates ◽

Predictive Utility ◽

Patent Ductus

Abstract Background The management of patent ductus arteriosus in preterm neonates continues to be a topic of discussion and controversy. Prolonged ductal patency in preterm neonates has been associated with significant short and long term morbidities and with increased mortality however, policy of routine treatment of all during neonatal period has failed to show significant improvement in long term outcome. Echocardiography has emerged as a promising modality to screen the newborns at risk of adverse effects of ductal shunting. This helps in identifying PDAs that require treatment to ultimately prevent unnecessary therapy or delay of necessary therapy. There are multitude of studies that have evaluated large number of echocardiographic markers for their predictive utility but only few have included all ductal markers together in a single study. The reported sensitivity (26-100%) and specificity (6-100%) of echocardiographic markers vary over a wide range. Thus, this study was planned with an aim to assess the predictive utility of all available ductal markers and their added advantage of having all over few ones in clinically apparent PDA in preterm VLBW newborns.Methods It was an observational prospective study conducted in tertiary care NICU at Lady Hardinge Medical College, Delhi. Fifty preterm very low birth weight (VLBW) newborns underwent four sequential Echo scans within first 72 hrs; first scan within 12 hours then at 24 hrs ,48 hrs and 72 hrs of age and were monitored clinically for the signs of PDA up to two weeks of life or discharge whichever comes later.Results The Ductal diameter, pulsatile ductal flow pattern, Left pulmonary artery (LPA) velocity, Left atrial to aortic width (La/Ao) ratio, Left atrial volume index (LAVI), Left ventricle to aortic width (Lv/Ao) ratio, E/A ratio and Left ventricular output/superior vena caval (LVO/SVC) flow ratio predicted clinically apparent PDA during first 72 hours of life.Conclusion This study provides insights into the predictive utility of other ductal echo markers along with the routinely measured conventional ones during first 72 hours of life in preterm VLBW newborns.

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Early Pulmonary Interstitial Emphysema in Preterm Neonates—Respiratory Management and Case Report in Nonventilated Very Low Birth Weight Twins

American Journal of Perinatology Reports ◽

10.1055/s-0038-1648253 ◽

2018 ◽

Vol 08 (02) ◽

pp. e99-e105 ◽

Cited By ~ 2

Author(s):

Judith Gronbach ◽

Harald Ehrhardt ◽

Klaus-Peter Zimmer ◽

Markus Waitz

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Respiratory Acidosis ◽

Current Evidence ◽

Preterm Neonates ◽

Management Options ◽

Pulmonary Interstitial Emphysema ◽

Interstitial Emphysema ◽

Respiratory Management

AbstractEarly pulmonary interstitial emphysema in extreme preterm neonates is closely linked with respiratory distress syndrome and exposure to mechanical ventilation. In severe cases, maintaining adequate gas exchange aiming to avoid further lung damage and other neonatal morbidities associated with systemic/pulmonary hypoperfusion, prolonged hypoxia, and respiratory acidosis can be challenging and requires in-depth knowledge into the pathophysiology of the disease. Herein, we report on very low birth weight twins who developed early pulmonary interstitial emphysema during noninvasive respiratory support. We further review the current evidence from the literature, specifically addressing on possible preventive measures and the respiratory management options of this acute pulmonary disease in high-risk neonates.

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Fathers' Visitation of Very Low Birth Weight Infants in the Neonatal Intensive Care Unit during the First Week of Life

American Journal of Perinatology ◽

10.1055/s-0039-3402750 ◽

2020 ◽

Author(s):

Khushbu Patel ◽

Lindsay Cortright ◽

Dmitry Tumin ◽

John A. Kohler

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Low Birth Weight ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Preterm Neonates ◽

Vlbw Infants ◽

Extremely Preterm

Abstract Background The perceived fragility of extremely preterm neonates may deter paternal visitation early during the neonatal intensive care unit (NICU) stay. We retrospectively analyzed the correlation between paternal visitation of very low birth weight (VLBW) infants in our NICU and sociodemographic characteristics. Study Design We identified inborn VLBW infants admitted to our NICU from 2017 to 2018. The rate of visit days in the first week of life was analyzed using Spearman's correlation and Poisson's regression. Results The analysis included 292 infants (median gestational age [GA]: 29 weeks), with fathers present on a median of 3 days of the first week of life. GA was not correlated with visitation (rho = –0.04). On multivariable regression, fathers visited less frequently if they did not live with the mother or if the mother lived 25 to 75 km from the hospital versus < 25 km. Conclusion Fathers' visitation in our NICU was constrained by socioeconomic factors rather than VLBW infants' characteristics.

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