scholarly journals The Multi-Component Causes of Late Neonatal Sepsis—Can We Regulate Them?

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 243
Author(s):  
Magdalena Pilarczyk-Zurek ◽  
Grzegorz Majka ◽  
Beata Skowron ◽  
Agnieszka Baranowska ◽  
Monika Piwowar ◽  
...  
Keyword(s):  
Bacterial Translocation ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Intraperitoneal Administration ◽  
Intestinal Barrier ◽  
Oral Intake ◽  
Intestinal Bacteria ◽  
Stress Factors ◽  
Rat Pups

Elucidating the mechanisms of bacterial translocation is crucial for the prevention and treatment of neonatal sepsis. In the present study, we aimed to evaluate the potential of lactoferrin to inhibit the development of late-onset blood infection in neonates. Our investigation evaluates the role of key stress factors leading to the translocation of intestinal bacteria into the bloodstream and, consequently, the development of life-threatening sepsis. Three stress factors, namely weaning, intraperitoneal administration of Gram-positive cocci and oral intake of Gram-negative rods, were found to act synergistically. We developed a novel model of rat pups sepsis induced by bacterial translocation and observed the inhibition of this process by supplementation of various forms of lactoferrin: iron-depleted (apolactoferrin), iron-saturated (hololactoferrin) and manganese-saturated lactoferrin. Additionally, lactoferrin saturated with manganese significantly increases the Lactobacillus bacterial population, which contributes to the fortification of the intestinal barrier and inhibits the translocation phenomenon. The acquired knowledge can be used to limit the development of sepsis in newborns in hospital neonatal intensive care units.

scholarly journals Role of Lumbar Puncture in Late Onset Neonatal Sepsis

2019 ◽  
Vol 39 (3) ◽  
pp. 155-161
Author(s):  
Amit Kumar Das ◽  
Deepak Mishra ◽  
Nitu Kumari Jha ◽  
Rakesh Mishra ◽  
Soniya Jha
Keyword(s):  
Blood Culture ◽  
Lumbar Puncture ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Signs And Symptoms ◽  
Clinical Syndrome ◽  
Neonatal Deaths ◽  
Late Onset Sepsis

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.

scholarly journals QUALITATIVE REVIEW OF ANTIBIOTIC USE FOR NEONATAL SEPSIS

2018 ◽  
Vol 10 (1) ◽  
pp. 364
Author(s):  
Tjio Ie Wei ◽  
Purwantyastuti Ascobat ◽  
Rinawati Rohsiswatmo ◽  
Insti Instiaty
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Antibiotic Use ◽  
Klebsiella Pneumonia ◽  
First Line ◽  
Normal Birth ◽  
Late Onset Sepsis ◽  
Sensitivity Tests ◽  
Blood Specimens

Objective: The aim of this study is to evaluate the antibiotic use in neonates with sepsis.Methods: An observational retrospective study was conducted using medical records of neonates diagnosed with early-/late-onset sepsis who wereprescribed antibiotics and who were treated in the neonatal intensive care unit (NICU) at the Dr. Cipto Mangunkusumo Hospital between January 1 andDecember 31, 2015. Patient records were screened for antibiotic use; qualitative analyses were performed using the Gyssens algorithm. Concordanceof empirical antibiotic prescriptions with subsequent blood culture and sensitivity tests was evaluated.Results: A total of 176 sepsis cases included 80 and 96 neonates with normal and low birth weights (LBWs), respectively. Ampicillinsulbactam+gentamycin, which is indicated in local guidelines as the first-line antibiotic combination for neonatal sepsis, was most frequentlyprescribed. In the normal birth weight group, appropriate antibiotic use (Gyssens Category I) was found in 89.7% of cases, whereas Gyssens Category V(no indication) was found in 4.54% of cases. In the LBW group, 88.1% and 6.2% of cases were included in Gyssens Categories I and V, respectively.Only 17.5% and 13.5% cultured blood specimens from normal and LBW groups, respectively, yielded positive results; the most commonly identifiedbacteria were Acinetobacter baumannii and Klebsiella pneumonia. All isolates were resistant to ampicillin-sulbactam; only 7.4% were sensitive togentamicin.Conclusion: Antibiotic use for neonatal sepsis in NICU in this study can be considered appropriate, suggesting proper implementation of antimicrobialguidelines. However, high rates of resistance to the first-line antibiotics for neonatal sepsis are concerning.

scholarly journals Intestinal Barrier Dysfunction, Bacterial Translocation and Inflammation: Deathly Triad in Sepsis

2021 ◽  
Author(s):  
Bercis Imge Ucar ◽  
Gulberk Ucar
Keyword(s):  
Bacterial Translocation ◽  
Current Knowledge ◽  
Intestinal Barrier ◽  
Intestinal Bacteria ◽  
Mucosal Barrier ◽  
High Morbidity ◽  
Barrier Dysfunction ◽  
Intestinal Barrier Dysfunction ◽  
Gut Mucosa ◽  
Sepsis Detection

Sepsis, as a complex entity, comprises multiple pathophysiological mechanisms which bring about high morbidity and mortality. The previous studies showed that the gastrointestinal tract is damaged during sepsis, and its main symptoms include increased permeability, bacterial translocation (BT), and malabsorption. BT is the invasion of indigenous intestinal bacteria via the gut mucosa to other tissues. It occurs in pathological conditions such as disruption of the intestine’s ecological balance and mucosal barrier permeability, immunosuppression, and oxidative stress through transcellular/paracellular pathways and initiate an excessive systemic inflammatory response. Thereby, recent clinical and preclinical studies focus on the association between sepsis and intestinal barrier dysfunction. This chapter overviews the current knowledge about the molecular basis of BT of the intestine, its role in the progress of sepsis, detection of BT, and actual therapeutic approaches.

scholarly journals Sepsis profile and outcome of preterm neonates admitted to neonatal intensive care unit of Cairo University Hospital

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Khaled Salama ◽  
Amira Gad ◽  
Sarah El Tatawy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Scoring System ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
University Hospital ◽  
Preterm Neonates ◽  
Early Onset Sepsis

Abstract Background This study demonstrates the experience of the neonatal intensive care unit (NICU) of a tertiary referral center in Egypt in management of prematures with neonatal sepsis. This retrospective study included preterm neonates admitted to NICU with clinical and/or laboratory diagnosis of sepsis. Blood culture was done followed by antimicrobial susceptibility testing for positive cases. Neonates with sepsis were classified into early onset sepsis (EOS) and late onset sepsis (LOS). Hematological scoring system (HSS) for detection of sepsis was calculated. Results The study included 153 cases of neonatal sepsis; 63 (41.2%) EOS and 90 (58.8%) LOS. The majority of the neonates had very low or moderately low birth weight (90.9%). All neonates received first-line antibiotics in the form of ampicillin-sulbactam, and gentamicin. Second-line antibiotics were administered to 133 neonates (86.9%) as vancomycin and imipenem-cilastatin. Mortalities were more common among EOS group (p < 0.017). Positive blood cultures were detected in 61 neonates (39.8%) with a total number of 66 cultures. The most commonly encountered organisms were Klebsiella MDR and CoNS (31.8% each). Klebsiella MDR was the most predominant organism in EOS (28.9%), while CoNS was the most predominant in LOS (39.2%) The detected organisms were divided into 3 families; Enterobacteriaceae, non-fermenters, and Gram-positive family. There 3 families were 100% resistant to ampicillin. The highest sensitivity in Enterobacteriaceae and Non-fermenters was for colistin and polymyxin-B. An HSS of 3–8 had a sensitivity and specificity of 62.3% and 57.6%, respectively for diagnosis of culture-proven sepsis. Conclusion Neonatal sepsis was encountered in 21.5% of admitted preterm neonates; LOS was more common (58.8%). Mortality was 51.6%. Klebsiella MDR and CoNS were the most commonly encountered organisms in both EOS and LOS. The isolated families were 100% resistant to ampicillin. The hematological scoring system (HSS) showed limited sensitivity for detection of sepsis.

scholarly journals Neonatal sepsis-blood culture, antibiotic stewardship and clinico-bacteriological study

2020 ◽  
Vol 7 (12) ◽  
pp. 2376
Author(s):  
Purva Shah ◽  
Ketan Gadhvi ◽  
Bharat Muliya ◽  
Khushi Shah
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Newborn Infants ◽  
Tertiary Hospital ◽  
Resistance Pattern ◽  
Bacteriological Study ◽  
Mortality And Morbidity ◽  
Early Onset Sepsis ◽  
Septic Focus

Background: Neonatal sepsis refers to an infection involving bloodstream in newborn infants less than 28 days old. It continues to remain a leading cause of morbidity and mortality among infants, especially in middle and lower-income countries. Neonatal sepsis is divided into 2 groups based on the time of presentation after birth: early-onset sepsis and late-onset sepsis.Methods: This study was done in the neonatal intensive care unit of tertiary hospital, Surendranagar. Study design being observational, data collected from clinical examination and records of the neonates admitted with positive septic screen, neonates admitted with suspected clinical sepsis (temperature >990F or <950F, respiratory rate more than 60 per minute, change in behavior, abnormal cry, not accepting feed, drowsy or unconscious, septic focus on skin or umbilicus, diarrhea and seizures) and neonates admitted with culture positive sepsis.Results: As per this research, neonatal sepsis has more male preponderance, with more commonly occurring in low birth weights and preterm. Klebsiella, Staphylococcus aureus and Pseudomonas being the most isolated organisms. Their resistance pattern, antibiotic profile and newer trends also came across.Conclusions: Neonatal sepsis comes as one of the major causes of mortality and morbidity of the newborns admitted. By this research, analyzing the sex, age, gestational weeks, organism isolated and the antibiotic profile, emerging new resistance and newer useful antibiotics can thus be studied and can be taken as a base for further study as well as evaluation of the same, along with also guiding to manage and treat neonatal sepsis better.

scholarly journals TRANSLOCATION OF INTESTINAL MICROFLORA IN CIRRHOSIS

2020 ◽  
Vol 4 (2) ◽  
pp. 143-150
Author(s):  
D. I. Haurylenka ◽  
◽  
N. N. Silivontchik ◽  
Keyword(s):  
Bacterial Translocation ◽  
Bacterial Infections ◽  
Intestinal Microflora ◽  
Intestinal Barrier ◽  
Intestinal Bacteria ◽  
Cochrane Collaboration ◽  
Russian Language ◽  
Intestinal Lumen ◽  
Future Research ◽  
Inflammatory Status

Background. Understanding of intestinal bacteria-host interaction physiology as well as bacterial translocation characteristics at the initial stages and in advanced cirrhosis emphasizes the importance of approaches minimizing the migration of microorganisms and their components from the intestinal lumen. Objective – to provide a brief review of publications highlighting the problem of bacterial intestinal translocation as the main mechanism for the development of bacterial infections and pro-inflammatory status in patients with liver cirrhosis. Material and methods. We performed the study and analysis of English- and Russian-language articles over the past 30 years contained in the following databases: PubMed, Cochrane Collaboration, UpToDate. The key words were: «intestinal microflora translocation», «bacterial translocation», «translocation markers». Results. Contemporary views on changes of the intestinal barrier and those of innate and adaptive immunity systems in liver diseases are considered. Data on possibility and signifcance of detecting bacterial translocation are presented.Current methods used for gut microbiome analysis as well as some areas for future research are discussed. Conclusion. A validated marker/markers is required to study bacterial translocation in cirrhosis.

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