scholarly journals mir-23b: A New Molecular Marker For Neonatal Sepsis In Haemoculture

2020 ◽  
Author(s):  
Ahlam Fatmi ◽  
Sid Ahmed Rebiahi ◽  
Nafissa Chabni ◽  
Hanane Zerrouki ◽  
Hafsa Azzaoui ◽  
...  

Abstract Background: Neonatal sepsis remains an important cause of morbidity and mortality. The ability to quickly and accurately diagnose neonatal sepsis based on clinical assessments and laboratory blood tests remains difficult, where haemoculture is the gold standard for detecting bacterial sepsis in blood culture. It is also very difficult to study because neonatal samples are lacking. Methods : Fifty-four newborns suspected of sepsis admitted to the Neonatology Department of the Mother-Child Specialized Hospital of Tlemcen. From each newborn, a minimum of 1-2 ml of blood was drawn by standard sterile procedures for blood culture. The miRNA-23b level in haemoculture was evaluated by RT-qPCR. Results : miR-23b levels increased in premature and full-term newborns in early onset sepsis ( p < 0.001 and p < 0.005 respectively), but lowered in late onset sepsis in premature and full-term neonates ( p < 0.005) compared to the respective negative controls. miR-23b levels also increased in late sepsis negative versus early sepsis negative controls ( p < 0.05). miR-23b levels significantly lowered in the newborns who died from both sepsis types ( p < 0.0001 and p < 0.05 respectively). Conclusions : The drop in miR-23b levels is an important factor that favours sepsis development, which would confirm their vital protective role, and strongly suggest that they act as a good marker in both molecular diagnosis and patient monitoring.

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Ahlam Fatmi ◽  
Sid Ahmed Rebiahi ◽  
Nafissa Chabni ◽  
Hanane Zerrouki ◽  
Hafsa Azzaoui ◽  
...  

Abstract Background Neonatal sepsis remains an important cause of morbidity and mortality. The ability to quickly and accurately diagnose neonatal sepsis based on clinical assessments and laboratory blood tests remains difficult, where haemoculture is the gold standard for detecting bacterial sepsis in blood culture. It is also very difficult to study because neonatal samples are lacking. Methods Forty-eight newborns suspected of sepsis admitted to the Neonatology Department of the Mother-Child Specialized Hospital of Tlemcen. From each newborn, a minimum of 1–2 ml of blood was drawn by standard sterile procedures for blood culture. The miRNA-23b level in haemoculture was evaluated by RT-qPCR. Results miR-23b levels increased in premature and full-term newborns in early onset sepsis (p < 0.001 and p < 0.005 respectively), but lowered in late onset sepsis in full-term neonates (p < 0.05) compared to the respective negative controls. miR-23b levels also increased in late sepsis in the negative versus early sepsis negative controls (p < 0.05). miR-23b levels significantly lowered in the newborns who died from both sepsis types (p < 0.0001 and p < 0.05 respectively). In early sepsis, miR-23b and death strongly and negatively correlated (correlation coefficient = − 0.96, p = 0.0019). In late sepsis, miRNA-23b and number of survivors (correlation coefficient = 0.70, p = 0.506) positively correlated. Conclusions Lowering miR-23b levels is an important factor that favours sepsis development, which would confirm their vital protective role, and strongly suggest that they act as a good marker in molecular diagnosis and patient monitoring.


2020 ◽  
Author(s):  
Ahlam Fatmi ◽  
Sid Ahmed Rebiahi ◽  
Nafissa Chabni ◽  
Hanane Zerrouki ◽  
Hafsa Azzaoui ◽  
...  

Abstract Background: Neonatal sepsis remains an important cause of morbidity and mortality. The ability to quickly and accurately diagnose neonatal sepsis based on clinical assessments and laboratory blood tests remains difficult, where haemoculture is the gold standard for detecting bacterial sepsis in blood culture. It is also very difficult to study because neonatal samples are lacking. Methods : Forty-eight newborns suspected of sepsis admitted to the Neonatology Department of the Mother-Child Specialized Hospital of Tlemcen. From each newborn, a minimum of 1-2 ml of blood was drawn by standard sterile procedures for blood culture. The miRNA-23b level in haemoculture was evaluated by RT-qPCR. Results : miR-23b levels increased in premature and full-term newborns in early onset sepsis ( p < 0.001 and p < 0.005 respectively), but lowered in late onset sepsis in full-term neonates ( p < 0.05) compared to the respective negative controls. miR-23b levels also increased in late sepsis in the negative versus early sepsis negative controls ( p < 0.05). miR-23b levels significantly lowered in the newborns who died from both sepsis types ( p < 0.0001 and p < 0.05 respectively). In early sepsis, miR-23b and death strongly and negatively correlated (correlation coefficient = -0.96, p = 0.0019). In late sepsis, miRNA-23b and number of survivors (correlation coefficient = 0.70, p = 0.506) positively correlated. Conclusions : Lowering miR-23b levels is an important factor that favours sepsis development, which would confirm their vital protective role, and strongly suggest that they act as a good marker in molecular diagnosis and patient monitoring.


2020 ◽  
Author(s):  
Ahlam Fatmi ◽  
Sid Ahmed Rebiahi ◽  
Nafissa Chabni ◽  
Hanane Zerrouki ◽  
Hafsa Azzaoui ◽  
...  

Abstract Background: Neonatal sepsis remains an important cause of morbidity and mortality. The ability to quickly and accurately diagnose neonatal sepsis based on clinical assessments and laboratory blood tests remains difficult, where haemoculture is the gold standard for detecting bacterial sepsis in blood culture. It is also very difficult to study because neonatal samples are lacking. Methods: Forty-eight newborns suspected of sepsis admitted to the Neonatology Department of the Mother-Child Specialized Hospital of Tlemcen. From each newborn, a minimum of 1-2 ml of blood was drawn by standard sterile procedures for blood culture. The miRNA-23b level in haemoculture was evaluated by RT-qPCR.Results: miR-23b levels increased in premature and full-term newborns in early onset sepsis (p < 0.001 and p < 0.005 respectively), but lowered in late onset sepsis in full-term neonates (p < 0.05) compared to the respective negative controls. miR-23b levels also increased in late sepsis in the negative versus early sepsis negative controls (p < 0.05). miR-23b levels significantly lowered in the newborns who died from both sepsis types (p < 0.0001 and p < 0.05 respectively). In early sepsis, miR-23b and death strongly and negatively correlated (correlation coefficient = -0.96, p = 0.0019). In late sepsis, miRNA-23b and number of survivors (correlation coefficient = 0.70, p = 0.506) positively correlated.Conclusions: Lowering miR-23b levels is an important factor that favours sepsis development, which would confirm their vital protective role, and strongly suggest that they act as a good marker in molecular diagnosis and patient monitoring.


Author(s):  
Poonam Dalal ◽  
Geeta Gathwala ◽  
Mohit Gupta ◽  
Jasbir Singh

Background: Neonatal sepsis is a leading cause of neonatal mortality and continues to be a formidable problem for neonatologists and pediatricians world over.  Knowledge of microbial flora and their susceptibility will help us to decide empirical treatment for the neonatal sepsis. The objective of this study was to determine the bacteriological flora prevalent in NICU and the antimicrobial sensitivity pattern.Methods: The blood culture reports of all the neonates with culture proven neonatal sepsis during the period July 2010 to September 2013 were reviewed retrospectively. A retrospective review in tertiary care teaching medical college. The data was entered in Excel sheets and percentages of various outcomes were calculated.Results: A total of 28,927 babies were born during the study period and 336 among them had positive blood culture. The incidence of neonatal sepsis was 11.62 per 1,000 live births. Three hundred fifty- six microbes were isolated, out of which 50% presented as early onset sepsis and remaining as late onset sepsis. Pseudomonas aeruginosa was the most common organism encountered in both early (43.82%) and late onset sepsis (51.35%). Gram negative bacilli were sensitive to carbapenems (92%) followed by piperacillin-tazobactam (90%) whereas linezolid (90%) was most sensitive antimicrobial for gram positive cocci.Conclusions: Pseudomonas was most commonly isolated in both early and late onset sepsis.  Gram negative bacilli were most sensitive to piperacillin-tazobactam and the carbapenems whereas linezolid and vancomycin were most effective against the gram-positive cocci. Resistance to third generation cephalosporins was rampant. Continuous surveillance for microbial flora, their antibiotic susceptibility, rational use of antibiotics and the strategy of antibiotic cycling may be of help to curtail emerging antimicrobial resistance.


2020 ◽  
Vol 35 (2) ◽  
pp. 130-134
Author(s):  
Md Mosharaf Hossain ◽  
Mir Mohammad Yusuf ◽  
Md Kamrunzzaman ◽  
Maksudur Rahman ◽  
Md Jahangir Alam

Background: Septicemia in neonates refers to bacterial infection documented by positive blood culture in the first four weeks of life and is one of the leading causes of neonatal mortality and morbidity. Objective: To isolate and identify the bacterial etiologic agents responsible for neonatal sepsis and to determine the susceptibility pattern of isolates in A NICU of Dhaka Shishu (Children) Hospital. Methods: This is a prospective observational study conducted in the NICU from July 2018 to December 2018. Two hundred ninty blood samples were collected and processed from patients in accordance with standard protocols. Antibiotic susceptibility of the isolates was done. Results: Blood culture reports were positive in 9.31% cases. Among the culture positive cases, there were 65.5% males and 34.5% females. Early onset sepsis was present in 74.8% and late onset sepsis was observed in 25.2% of the cases. Best overall sensitivity among Gram negative (Acinetobacter, Klebsiella, Pseudomonas) isolates was to netilmycin (61%), followed by ceftazidim (57%) and amikacin (56%).Gram positive (Staphylococci, streptococci) isolates had sensitivity of 50% to levofloxacin, 50% to ceftriaxon. Conclusion: Gram negative organisms are the leading cause of neonatal sepsis in this study and most of them are resistant to multiple antibiotics. Therefore the results of this study suggest that, surveillance of antimicrobial resistance in our hospital is necessary. DS (Child) H J 2019; 35(2) : 130-134


Author(s):  
Pramod P. Singhavi

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.


Author(s):  
Sagori Mukhopadhyay ◽  
Karen M Puopolo ◽  
Nellie I Hansen ◽  
Scott A Lorch ◽  
Sara B DeMauro ◽  
...  

ObjectiveDetermine risk of death or neurodevelopmental impairment (NDI) in infants with late-onset sepsis (LOS) versus late-onset, antibiotic-treated, blood culture-negative conditions (LOCNC).DesignRetrospective cohort study.Setting24 neonatal centres.PatientsInfants born 1/1/2006–31/12/2014, at 22–26 weeks gestation, with birth weight 401–1000 g and surviving >7 days were included. Infants with early-onset sepsis, necrotising enterocolitis, intestinal perforation or both LOS and LOCNC were excluded.ExposuresLOS and LOCNC were defined as antibiotic administration for ≥5 days with and without a positive blood/cerebrospinal fluid culture, respectively. Infants with these diagnoses were also compared with infants with neither condition.OutcomesDeath or NDI was assessed at 18–26 months corrected age follow-up. Modified Poisson regression models were used to estimate relative risks adjusting for covariates occurring ≤7 days of age.ResultsOf 7354 eligible infants, 3940 met inclusion criteria: 786 (20%) with LOS, 1601 (41%) with LOCNC and 1553 (39%) with neither. Infants with LOS had higher adjusted relative risk (95% CI) for death/NDI (1.14 (1.05 to 1.25)) and death before follow-up (1.71 (1.44 to 2.03)) than those with LOCNC. Among survivors, risk for NDI did not differ between the two groups (0.99 (0.86 to 1.13)) but was higher for LOCNC infants (1.17 (1.04 to 1.31)) compared with unaffected infants.ConclusionsInfants with LOS had higher risk of death, but not NDI, compared with infants with LOCNC. Surviving infants with LOCNC had higher risk of NDI compared with unaffected infants. Improving outcomes for infants with LOCNC requires study of the underlying conditions and the potential impact of antibiotic exposure.


2019 ◽  
Vol 39 (3) ◽  
pp. 155-161
Author(s):  
Amit Kumar Das ◽  
Deepak Mishra ◽  
Nitu Kumari Jha ◽  
Rakesh Mishra ◽  
Soniya Jha

Introduction: Neonatal sepsis is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life.  It is responsible for about 30-50% of the total neonatal deaths in developing countries.  Neonatal sepsis can be divided into two sub-types depending upon whether the onset of symptoms within the first 72 hours of life (Early Onset Neonatal Sepsis) or after 72 hours of life (Late Onset Neonatal Sepsis ).  Meningitis is an important complication of late onset neonatal sepsis. Method: This was hospital based prospective observational study conducted among the neonates admitted with diagnosis of late onset neonatal sepsis in Neonatal Intermediate Care Unit (NIMCU) and Neonatal Intensive Care Unit (NICU) of Kanti Children’s Hospital from July 2016 to June 2017. The objective of this study was to evaluate the importance of performing LP in neonates with LONS. Results: 16.8% neonates with late onset neonatal sepsis were found to have meningitis. Among the neonates with meningitis CRP was positive 57.2% and negative in 42.8 %.  Among the cases with abnormal CSF findings, blood culture was sterile in 85% cases and organism was isolated 15% cases. In 88.8% cases with positive blood culture, no meningitis was detected. Lumbar puncture was traumatic in 1 neonate (0.8%) in first attempt. Apart from this no other complication of performing lumbar puncture was noted. Conclusion: Lumbar puncture and CSF examination is mandatory in all cases with late-onset sepsis.


2017 ◽  
Vol 07 (01) ◽  
pp. e54-e59 ◽  
Author(s):  
S. Blatt ◽  
M. Schroth

AbstractUnspecific symptoms and rapid development of sepsis up to septic shock from systemic inflammatory response syndrome (SIRS) are well-known, important issues in neonatology. A common cause is the infection by Streptococcus agalactiae (Group B Streptococcus [GBS]) or Escherichia coli, which contributes significantly to neonatal morbidity and mortality. Whereas early-onset sepsis is normally derived from mother during birth, late-onset sepsis can be transmitted by the environment. Management of neonatal sepsis includes the maintenance of cardiovascular and pulmonary function besides antibiotic therapy. Due to the fact that until today, there are no reliable screening tests for detecting early sepsis, clinical assessment is considered to be of utmost importance.


2019 ◽  
Vol 6 (3) ◽  
pp. 917
Author(s):  
Gh Rasool Wani ◽  
Nazir Ahmed ◽  
Mohd Irshad ◽  
Mohd Ashraf ◽  
Bashir Ahmed Teli

Background: Neonatal sepsis refers to generalized bacterial blood stream infection in first 28 days of life documented by positive blood cultures. It is one of leading causes of neonatal mortality. Objectives was to study clinicobacteriological, antibiotic sensitivity patterns and mortality of neonatal sepsis.Methods: This prospective study was conducted in the Department of Pediatrics of Government Medical College Srinagar in collaboration with Department of Microbiology of same medical college after ethical clearance from ethical committee of Government Medical College Srinagar. One hundred (100) neonates out of 731 neonates admitted between octomber2007 and September 2008 with signs and symptoms of neonatal sepsis were included in our study by random sampling method. After history, examination and laboratory investigation blood culture results were analyzed by standard statistical methods.Results: The blood culture was positive in 40% of neonates. Fifty one (51) neonates were males while as 49 were females. Sixty three (63) neonates had late onset of sepsis while as 37 had early onset sepsis. The positive  blood culture was more common in males, late onset sepsis, babies born in rural areas, home born, vaginal births, preterm and other  low birth weight neonates .The gram negative isolates were most common followed by positive ones .The best sensitivity of gram negative isolates was to ciprofloxacin followed by amikacin and cephalosporins while as gram positive isolates were sensitive to imipenum followed by vancomycin. Pseudomonas was most responsive to pipercillin +tazobactum combination. The neonatal mortality was 35% being higher in early onset sepsis and low birth weights.Conclusions: This study depicts a high rate of neonatal sepsis, mainly caused by gram negative organisms followed by gram positive organisms with rising drug resistance that could bear far reaching implications to the times to come, mandating the implementation of sepsis preventive measures and administration of specific antibiotics.


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