Clinical and Laboratory Findings of Nosocomial Sepsis in Extremely Low Birth Weight Infants According to Causative Organisms

Background: nosocomial sepsis remains a significant source of morbidity and mortality in extremely low birth weight (ELBW) infants. Early and accurate diagnosis is very important, but it is difficult due to the similarities in clinical manifestation between the causative microorganisms. We tried to identify the differences between causative microorganisms in clinical and laboratory findings and to help choose antibiotics, when sepsis was suspected in ELBW infants. Methods: a retrospective study was conducted on preterm infants, born at less than 28 weeks of gestation, with a birth weight of less than 1000 g between January 2009 and December 2019. Clinical and laboratory findings of suspected sepsis, after the first 72 h of life, were assessed. We classified them into four groups according to blood culture results (gram positive, gram negative, fungal, and negative culture groups) and compared them. Results: a total of 158 patients were included after using the exclusion criteria, with 45 (29%) in the gram positive group, 35 (22%) in the gram negative group, 27 (17%) in the fungal group, and 51 (32%) in the negative culture group. There were no significant differences in mean gestational age, birth weight, and neonatal morbidities, except for the age of onset, which was earlier in the fungal group than other groups. White blood cell (WBC) counts were the highest in the gram negative group and the lowest in the fungal group. The mean platelet counts were the lowest in the fungal group. C-reactive protein (CRP) levels were the highest in the gram negative group, while glucose was the highest in the fungal group. Conclusions: in conclusion, we showed that there are some differences in laboratory findings, according to causative microorganisms in the nosocomial sepsis of ELBW infants. Increased WBC and CRP were associated with gram negative infection, while decreased platelet and glucose level were associated with fungal infection. These data may be helpful for choosing empirical antibiotics when sepsis is suspected.

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Clinical And Laboratory Findings Of Late Onset Sepsis In Extremely Low Birth Weight Infants According To Causative Organisms

10.21203/rs.3.rs-444934/v1 ◽

2021 ◽

Author(s):

Kyung Hee Park ◽

Mi Hye Bae ◽

Na Rae Lee ◽

Young Mi Han ◽

Shin-Yun Byun

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Age Of Onset ◽

Late Onset ◽

Extremely Low Birth Weight ◽

Negative Group ◽

Gram Positive ◽

Laboratory Findings ◽

Gram Negative ◽

Late Onset Sepsis

Abstract Background: Late onset sepsis (LOS) remains a significant source of morbidity and mortality in extremely low birth weight (ELBW) infants. Early and accurate diagnosis is very important but is difficult due to the similarities in clinical manifestation between the causative microorganisms. We tried to identify the differences between causative microorganisms in clinical and laboratory findings, when sepsis was suspected in ELBW infants.Methods: A retrospective study was conducted on preterm infants born at less than 28 weeks of gestation with a birth weight of less than 1,000 g between January 2009 and December 2019. Clinical and laboratory findings of suspected LOS were assessed. We classified them into three groups according to blood culture results (gram-positive, gram-negative, and fungal groups) and compared them. Results: A total of 107 patients were included after using the exclusion criteria, with 45 (31.5%) in the gram-positive group, 35 (17.5%) in the gram-negative group, and 27 (11.5%) in the fungal group. There were no significant differences in mean gestational age, birth weight, and neonatal morbidities, except for the age of onset, which was earlier in the fungal group than in the bacterial groups. White blood cell (WBC) counts were the highest in the gram-negative group and the lowest in the fungal group. The mean platelet counts were significantly lower in the fungal group (137,000/mm3, 100,000/mm3, and 61,000/mm3 in the gram-positive, gram-negative, and fungal groups, respectively; p< 0.001). C-reactive protein (CRP) levels were significantly higher in the gram-negative group, while glucose was significantly higher in the fungal group. Conclusion: In conclusion, we showed that there are some differences in laboratory findings, according to causative microorganisms, in the LOS of ELBW infants. WBC and CRP were increased in gram-negative infection, and thrombocytopenia and hyperglycemia were predominant in fungal infection. These data may be helpful for choosing empirical antibiotics when sepsis is suspected.

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Clinical and bacteriological profile of neonatal sepsis with emerging resistance patterns

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20184281 ◽

2018 ◽

Vol 5 (6) ◽

pp. 2203 ◽

Cited By ~ 1

Author(s):

Rohitashwa Rajana ◽

Dhan Raj Bagri ◽

J. N. Sharma ◽

Vijay Agrawal

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Neonatal Sepsis ◽

Antibiotic Sensitivity ◽

Polymyxin B ◽

Laboratory Evaluation ◽

Gram Positive ◽

Gram Negative ◽

Bacteriological Profile ◽

Sensitivity Pattern

Background: The present study was designed to evaluate the clinical spectrum, bacteriological profile, antibiotic sensitivity pattern and mortality due to neonatal septicemia in neonates admitted in neonatal units attached to the SMS Medical College, Jaipur.Methods: In born and out born babies of postnatal age up to 28 days who were bacteriological proven cases of septicemia were subjected to history, clinical examination and laboratory evaluation and data were analyzed statistically.Results: Out of 150 cases 67.33% neonates were preterm and 77.33% were low birth weight neonates. Gram negative organisms were most common cause of septicemia (66.6%), Both the Gram negative and Gram positive organisms were sensitive to piperacillin-tazobactam, linezolid, fosfomycin, teicoplanin, polymyxin B, colistin, ofloxacin. Both the Gram negative and Gram positive organisms were resistant against cephalosporins, ampicillin, Amoxyclav, cotrimoxazole. Gram negative isolates were most sensitive to Polymyxin B (70%) and had the highest resistance to cefepime (36%). Gram-positive organisms were most sensitive to vancomycin (84%) and linezolid (82%). Highest resistance was noted from Amoxyclav (52%).Conclusions: Preterm (<37 week) and low birth weight (<2500gm) neonates are considered as major susceptible causes of neonatal sepsis. Proper hygiene and hand washing, early detection of sepsis and judicial use of antibiotics to prevent multidrug resistance is needful in our setup.

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A case of an infant with extremely low birth weight and hypothyroidism associated with massive cutaneous infantile hemangioma

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2018-0369 ◽

2018 ◽

Vol 31 (12) ◽

pp. 1377-1380

Author(s):

Aiko Igarashi ◽

Ikue Hata ◽

Miori Yuasa ◽

Takashi Okuno ◽

Yusei Ohshima

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Thyroid Function ◽

Infantile Hemangioma ◽

Extremely Low Birth Weight ◽

High Dose ◽

Hepatic Hemangioma ◽

Laboratory Findings ◽

Cutaneous Hemangioma ◽

Propranolol Therapy

Abstract Background Although hepatic infantile hemangioma (IH) may correlate with consumptive hypothyroidism consequent to the overexpression of thyroid hormone inactivating enzyme by hemangioma cells, hypothyroidism has been rarely recognized in infants with cutaneous hemangioma. Case presentation A male infant born at 28 weeks of gestational age with an extremely low birth weight (775 g) developed a massive cutaneous hemangioma on his neck and severe abdominal distension. Imaging examinations detected a small mass lesion in the brain but no hepatic hemangioma. Laboratory findings at the age of 26 days revealed hypothyroidism. Although high-dose levothyroxine therapy failed to normalize the thyroid function, hypothyroidism improved and cutaneous hemangioma regressed after initiating propranolol therapy. Conclusions Our findings suggest that consumptive hypothyroidism should be considered as a critical comorbidity in patients with massive cutaneous IH. Propranolol therapy can effectively normalize thyroid function and cause hemangioma regression.

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The Efficacy of Clinical Strategies to Reduce Nosocomial Sepsis in Extremely Low Birth Weight Infants

Journal of Korean Medical Science ◽

10.3346/jkms.2005.20.2.177 ◽

2005 ◽

Vol 20 (2) ◽

pp. 177 ◽

Cited By ~ 18

Author(s):

Jong Hee Hwang ◽

Chang Won Choi ◽

Yun Sil Chang ◽

Yon Ho Choe ◽

Won Soon Park ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infants ◽

Nosocomial Sepsis ◽

Clinical Strategies

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Screening Retinopathy of Prematurity in Extremely Low Birth Weight Infants in China and the Need for Earlier Screening Times

Journal of Ophthalmology ◽

10.1155/2016/7065835 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Jianxun Wang ◽

Feng Chen ◽

Shiping He ◽

Daoman Xiang

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Retinopathy Of Prematurity ◽

Age Of Onset ◽

Screening Strategy ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infants ◽

Group A ◽

The Mean

Purpose. To convey the need for a revised screening strategy for retinopathy of prematurity (ROP) for extremely low birth weight (ELBW) infants in China.Design. A retrospective longitudinal study.Methods. The medical charts of infants with a birth weight (BW) of less than 1 kg were reviewed. The infants were divided into three groups: group A, without ROP; group B, with ROP but not up to type 1 prethreshold or threshold ROP; group C, with type 1 prethreshold or threshold ROP. Data collected included gender, gestational age (GA), BW, postmenstrual age (PMA), age of onset of ROP, and age at which treatment was carried out, if required.Results. A total of 77 infants were involved. Fifty-six infants developed ROP at any stage and 38 infants developed type 1 prethreshold or threshold ROP. The mean BW and GA of infants in group A were significantly different compared with groups B and C. The mean PMA of onset of ROP in infants who developed mild ROP was 37 weeks compared with 34 weeks for infants who developed severe ROP.Conclusion. ELBW infants have a higher incidence of ROP in China which highlights the need for optimizing neonatal care for these infants. In ELBW infants, ROP tends to develop more severely when it occurs earlier. It is necessary for ELBW infants, especially for those with a BW less than 800 g or a GA less than 25 weeks, to be initially screened at an earlier time.

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