Early neonatal complications in pregnant women with gestational diabetes mellitus and the effects of glycemic control on neonatal infection

BACKGROUND Gestational diabetes mellitus(GDM)has become increasingly prevalent globally.Glycemic control in pregnant women with GDM has a critical role in neonatal complications.AIM To analyze the early neonatal complications in GDM,and examine the effect of blood glucose control level on neonatal infection.METHODS The clinical data of 236 pregnant women with GDM and 240 healthy pregnant women and newborns during from March 2020 to December 2021 the same period were retrospectively analyzed,and the early complications in newborns in the two groups were compared.The patients were divided into the conforming glycemic control group(CGC group)and the non-conforming glycemic control group(NCGC group)based on whether glycemic control in the pregnant women with GDM conformed to standards.Baseline data,immune function,infectionrelated markers,and infection rates in neonates were compared between the two groups.RESULTS The incidence of neonatal complications in the 236 neonates in the GDM group was significantly higher than that in the control group(P<0.05).Pregnant women with GDM in the NCGC group(n=178)had significantly higher fasting plasma glucose,2 h postprandial blood glucose and glycated hemoglobin A1C levels than those in the CGC group(n=58)(P<0.05).There were no differences in baseline data between the two groups(P>0.05).Additionally,the NCGC group had significantly decreased peripheral blood CD3^(+),CD4^(+),CD8^(+)T cell ratios,CD4/CD8 ratios and immunoglobulin G in neonates compared with the CGC group(P<0.05),while white blood cells,serum procalcitonin and C-reactive protein levels increased significantly.The neonatal infection rate was also significantly increased in the NCGC group(P<0.05).CONCLUSION The risk of neonatal complications increased in pregnant women with GDM.Poor glycemic control decreased neonatal immune function,and increased the incidence of neonatal infections.

Pantoea SPP: A New Nosocomial Infection in the Neonatal Intensive Care Unit

Pantoea SPP is a gram-negative bacillus, which usually colonizes plants, soil and water. This pathogen very rarely causes neonatal sepsis. The most common infections caused by Pantoea SPP are septic arthritis or synovitis, meningitis frequently complicated by brain abscess, upper respiratory infections, and peritonitis. We present the case of a premature infant who presented neonatal respiratory distress and whose evolution was complicated by the occurrence of a nosocomial infection for which a blood culture was performed isolating the germ Pantoea SPP. The patient’s management was initially centered on non-invasive ventilation with antibiotherapy based on carbapenem and aminoglycoside. Due to the clinical and biological worsening, the neonate was intubated and sedated and put on colymicin. The evolution was unfavorable marked by a death at 16th days of life. Considering the high pathogenicity of this germ and its multi-resistance to antibiotics, it is crucial to know the clinical spectrum of Panteoa SPP infections in neonatal intensive care units, in order to palliate the fulminant evolution of multifocal attacks due to this germ.

Nosocomial Klebsiella variicola Infection in Neonatal Intensive Care: A New Emerging Pathogen

Klebsiella variicola is a human pathogen that has been misidentified as K. pneumoniae. This misidentification has led to a lack of understanding of important clinical and biological aspects of this bacterial species. It is responsible for serious and potentially fatal infections, with a prevalence of multi-resistance to routine antibiotics. We present through three clinical observations, the case of three newborns having been hospitalized in the neonatal intensive care unit and whose evolution was complicated by the occurrence of a nosocomial infection in front of which a blood culture was done on blood agar, with a manual antibiogram on antibiotic disks, isolated the germ Klebsiella variicola. The management of the newborns was initially centered on non-invasive ventilation with a bi-antibiotic therapy based on carbapenem and amikacin for two newborns and switched to colymicin for the third case. Newborn follow-up was based on assessment of general condition, clinical signs of infection, as well as a biological control made of a blood count, a c-reactive protein, a complete ionogram, and a blood culture, every four days or if signs of clinical call. The evolution was favorable for two cases with good clinical and biological improvement, and complicated by death due to alveolar hemorrhage in the third case. Given the high pathogenicity of this germ, and the frequency of misidentification, it is crucial to know the clinical spectrum of Klebsiella variicola infections in neonatal intensive care units, in order to adapt the antibiotic therapy and to mitigate the fulminant evolution of this germ.

Salivary C-reactive protein and mean platelet volume as possible diagnostic markers for late-onset neonatal pneumonia

BACKGROUND Neonatal sepsis,a formidable threat to newborns,is a leading cause of neonatal mortality,with late-onset sepsis manifesting after 72 hours post-birth being particularly concerning.Pneumonia,a prevalent sepsis presentation,poses a significant risk,especially during the neonatal phase when lung defenses are compromised.Accurate diagnosis of pneumonia is imperative for timely and effective interventions.Saliva,a minimally invasive diagnostic medium,holds great promise for evaluating infections,especially in infants.AIM To investigate the potential of serum C-reactive protein(CRP),salivary CRP(sCRP),and mean platelet volume(MPV)as diagnostic markers for late-onset neonatal pneumonia(LONP).METHODS Eighty full-term neonates were systematically examined,considering anthropometric measurements,clinical manifestations,radiology findings,and essential biomarkers,including serum CRP,sCRP,and MPV.RESULTS The study reveals noteworthy distinctions in serum CRP levels,MPV,and the serum CRP/MPV ratio between neonates with LONP and healthy controls.MPV exhibited a robust discriminatory ability[area under the curve(AUC)=0.87]with high sensitivity and specificity at a cutoff value of>8.8.Correlations between serum CRP,sCRP,and MPV were also identified.Notably,sCRP demonstrated excellent predictive value for serum CRP levels(AUC=0.89),underscoring its potential as a diagnostic tool.CONCLUSION This study underscores the diagnostic promise of salivary and serum biomarkers,specifically MPV and CRP,in identifying and predicting LONP among neonates.These findings advocate for further research to validate their clinical utility in larger neonatal cohorts.

Neonatal rhesus monkeys as an animal model for rotavirus infection

AIM To establish a rotavirus(RV)-induced diarrhea model using RV SA11 in neonatal rhesus monkeys for the study of the pathogenic and immune mechanisms of RV infection and evaluation of candidate vaccines.METHODS Neonatal rhesus monkeys with an average age of 15-20 d and an average weight of 500 g ± 150 g received intragastric administration of varying doses of SA11 RV( 107 PFUs/mL, 106 PFUs/mL, or 105 PFUs/mL, 10 mL/animal) to determine whether the SA11 strain can effectively infect these animals by observing their clinical symptoms, fecal shedding of virus antigen by ELISA, distribution of RV antigen in the organs by immunofluorescence, variations of viral RNA load in the organs by qRT-PCR, histopathological changes in the small intestine by HE staining, and apoptosis of small intestinal epithelial cells by TUNEL assay.RESULTS The RV monkey model showed typical clinical diarrhea symptoms in the 108 PFUs SA11 group, where we observed diarrhea 1-4 d post infection(dpi) and viral antigen shed in the feces from 1-7 dpi. RV was found in jejunal epithelial cells. We observed a viral load of approximately 5.85 × 103 copies per 100 mg in the jejunum at 2 dpi, which was increased to 1.09 × 105 copies per 100 mg at 3 dpi. A relatively high viral load was also seen in mesenteric lymph nodes at 2 dpi and 3 dpi. The following histopathological changes were observed in the small intestine following intragastric administration of SA11 RV: vacuolization, edema, and atrophy. Apoptosis in the jejunal villus epithelium was also detectable at 3 dpi.CONCLUSION Our results indicate that we have successfully established a RV SA11 strain diarrhea model in neonatal rhesus monkeys. Future studies will elucidate the mechanisms underlying the pathogenesis of RV infection, and we will use the model to evaluate the protective effect of candidate vaccines.

Hand Hygiene Compliance in the Prevention of Nosocomial Infections in the Neonatal Unit of the National University Teaching Hospital of Cotonou

Objective: Despite the presence of hand washing material and the training given to medical staff regarding hygiene measures and health care procedures in October 2015, the prevalence of nosocomial infections in the neonatal unit of the National University Teaching Hospital of Cotonou (CNHU-Cotonou) was estimated at 8% in January 2016. To determine the factors that contribute to these infections, this study assessed medical staff compliance with hand hygiene measures and procedures. Method: This research was a cross-sectional and observational study conducted from February 15 to March 31, 2016 through direct and cautious observation of 47 members of the medical and paramedical staff. The study variables were hand washing before entering the neonatal unit and before entering each treatment room, hand washing before and after seeing each patient, compliance with hand washing steps, the use of hydroalcoholic solutions and adhering to the ban on mobile phone use inside the treatment room. Results: Only 15% of the medical staff followed all of the rules and measures governing hand hygiene. The result showed that 76.6% of them did not wash their hands before entering the unit;32% washed their hands before each care session;95.7% washed their hands after each care session;and 85% did not comply with the hand washing steps. Only 21.3% of the personnel used hydroalcoholic solution, and only 85% of the personnel adhered to the ban on mobile phone use within the treatment room. Conclusion: Compliance with hand hygiene measures is insufficient. These low compliance rates facilitate the occurrence of nosocomial infections. Nosocomial infections could be prevented by identifying the reasons that medical personnel do not wash their hands and by implementing a program for education/awareness on hygiene measures based on an analysis of errors and care procedures and sustained by regular evaluations.

Hematological Profile of Newborns Hospitalized for Neonatal Bacterial Infection in the Neonatology of the Pediatric Department of Gabriel Toure Teaching Hospital Bamako, Mali

The blood count is an easily achievable routine exam and will it have specifics in the event of a neonatal bacterial infection? Hence, the present study with the objective of determining the profile of the hemogram of newborns hospitalized for early bacterial neonatal infection. Material and methods: This was a cross-sectional study that took place from June 27 to September 03, 2016 in the neonatology department of teaching hospital Gabriel Toure. Included were all neonates hospitalized for early neonatal bacterial infection (ENBI) and who had a blood count. Results: We included 227 patients, 64.8% of whom were premature. The sex ratio was 1.4. The infants were less than 24 hours old in 93.6% of the cases. The mean hemoglobin level was 16.435 g/dl [8.8 - 22.26]. Erythrocytopenia was found in 18.5% of cases. Anemia was present in 17% of newborns. The average leukocyte was 15.228·103/mm3 [1.4 - 72]. Hyperleukocytosis and leukopenia were found in 12.32% and 6.6% respectively. Neutropenia and lymphopenia were present in 14.5% and 30.8%. There was a correlation between leukocytosis of negative blood cultures (23/27) (p = 0.030). For Neutrophils, neutrophilia was more observed in term neonates and neutropenia in premature infants (p = 0.03). Monocytosis was present in 13.6% of cases. One quarter (25.5%) of newborns had thrombocytopenia. Conclusion: Hematological variations did not allow a specific profile of newborns hospitalized for early neonatal bacterial infection to be identified.

Healthcare Associated Infection in the Neonatal Intensive Care Unit of King Abdl Aziz Specialist Hospital, Taif, KSA

Healthcare-associated infection is a common problem of newborn in neonatal intensive care units. It results in high mortality rate and serious complications. The Aim: to assess the incidence, etiology and the mortality of healthcareassociated infections of patients in neonatal intensive care unit at King Abdl Aziz Specialist Hospital (KAASH), Taif, Kingdom of Saudi Arabia. Material and Methods: This is a retrospective study including 8033 neonates admitted to neonatal intensive care unit during period between April, 2006 and December, 2012. The health-care associated infection rate, mortality rate, causative organism and risk factors were studied. Results: The prevalence of health-care associated infection was found to be 6.03%;the mortality rate was 27.1%. The highest prevalence was among children with the birth weight below 1000 g. The most frequent causative pathogen was klebseilla spp, followed by other gram negative bacilli. Conclusion: The rate of healthcare-associated infections in neonatal intensive care unit at KAASH was relatively high. In addition, the mortality rate was observed to be high (27.1%) owing to the high virulence of the causative organisms.

Neonatal Infection among Women with Prior Premature Labor

Objectives: Since studies demonstrate that neonates born to mothers having been cared for premature labor will suffer from congenital neonatal sepsis, we aimed to evaluate the prevalence and main risk factors of neonatal infection among mothers having experienced a prior premature labor. Methods: This was a cross sectional study carried out from January 1st throughout 31st December, 2013 at the university clinics of Kinshasa. It concerned all delivered women at term having been cared for premature labor prior to giving birth a live newborn. Maternal variables of interest were: parity, gestation, age, intrapartum fever, malaria, urogenital infection during the last 2 weeks before delivery (UGI), premature rupture of membranes (PROM), cervical cerclage, meconium-stained amniotic fluid (MSAF) and the way of delivery. For neonates attention was paid on gestational age, birth weight, admission at neonatal intensive care unit (ANICU) and infection as stated within three days after birth. T-test and Chi-square were used where appropriate. Logistic analysis was used to determine the risk for maternal variables to induce neonatal infection (OR and CI), the significance stated at p < 0.05. Results: Fifty two mother-infant couples were recruited. Of these 19 neonates were infected (prevalence of 36.5%). Mean age, gestational age and birth weight were 30.19 ± 5.32 years, 37.2 ± 2 weeks and 2638 ± 588 g, respectively. Infected neonates had their gestational age and birth weight significantly lower whilst proportion of ANICU higher than that on non infected. Prematurity, PROM, UGI, prior cerclage and MSAF were significantly more frequent in couples with neonatal infection. Prematurity, birth weight <2500 g and UGI were found to enhance the risk by 3 to 4 times. Conclusion: The prevalence of neonatal infection was very high. Prematurity, birth weight <2500 g and maternal UGI were found to enhance the risk by 3 to 4 times.

Late Neonatal Bacterial Infection at the Brazzaville Teaching Hospital

Background: Late Neonatal Bacterial Infection (LNNBI) is a clinical and biological manifestations related to penetration and growth of specific causative bacteria in bloodstream occurring on the 4th-28th day of life. LNNBI still represents an important cause of mortality and morbidity among infants. Objectives: To determine the frequency of late bacterial infections in newborns, to describe the clinical and biological profiles and to identify the main responsible germs. Methods: Descriptive study data collection, conducted over a period of 10 months at the Brazzaville Teaching Hospital, of interest to newborns admitted from the 4th day of life for suspicion of neonatal infection, and those admitted for any other pathology and having presented an infection 48 hours after hospitalization, and in whom a bacterial culture and/or an inflammatory assessment confirmed or suspected infection. Results: During the study period, 1682 newborns were hospitalized, and 86 were hospitalized for a late neonatal bacterial infection, i.e. a frequency of 5.1%. There were 67 (77.9%) community infections and 19 (22.1%) nosocomial infections. The frequency of nosocomial infection was 1.1%. The main signs were fever in 65 cases (75.6%), and respiratory distress in 37 cases (43%). The most frequent localizations were bacteremia 32 (37.2%), pulmonary 21 (24.4%), digestive and meningeal in 11 cases (12.8%) each. The most common germ Klebsiella in 10 (50%) newborns was resistant to the usual antibiotics. The evolution was favorable in 71 cases (82.5%), and death occurred in 12 cases (14%). Conclusion: Late neonatal bacterial infection is common. The main responsible germs are gram-negative bacilli, in particular Klebsiella multi-resistant.

Epidemic to Different Strains of SERRATIA: Experience of Neonatal Intensive Care Unit: About 30 Cases

Serratia is an opportunistic pathogenic bacterium of the Enterobacteriaceae family, occasionally responsible for epidemics of nosocomial infections in critical departments;in particular in neonatal intensive care units Enterobacteriaceae form a large family of Gram-negative bacteria, which cause diseases of highly variable severity, due to distinct pathogenic mechanisms. This family is heterogeneous as it consists of about 30 genera of bacteria and more than 100 species. However, all these germs have in common their preferential location in the digestive system, some being part of the normal flora although they are also present in the environment. Several metabolic processes characterize this bacterial family. These include the ability to reduce nitrate to nitrite (for energy generation), ferment glucose, lack cytochrome oxidase, be aerobic or anaerobic, motile or immobile, … Enterobacteriaceae constitute more than 80% of the germs isolated in the laboratory: Escherichia, Salmonella, Shigella, Klebsiella, Enterobacter, Serratia, Proteus, Morganella and Yersinia are the rods most often found. Regarding nosocomial infection to Serratia, this bacterium colonizes the respiratory, digestive and urinary systems of patients, mainly responsible for bacteremia, infections of the lower respiratory tract, urinary and skin infections. Through our work, we report the epidemic experienced in the neonatal intensive care unit MOHAMMED VI university hospital, mother-child hospital MARRAKECH MOROCCO for three months from December at February 2023 interesting 30 newborns whose clinical presentation was different, the positive diagnosis was based on blood and geographical samples taken by the bacteriology department to isolate the offending germs, the therapeutic management of our patients consisted essentially of various hygiene measures in association with dual antibiotic therapy based on meropenem and amikacin. The evolution was marked by the death of 21 patients (70%) and the recovery of 9 patients (30%). The prognosis of infection by serratia remains bleak with high morbidity interest in prevention by respecting the rules of hygiene, which begins with hand disinfection.

Neonatal Thrombocytopenia at Dakar Principal Hospital

Neonatal thrombocytopenia accounts for 20% of neonates hospitalized in the neonatal intensive care unit (NICU) at DPH. The etiologies are multiple, but bacterial infection is the third leading cause of neonatal mortality worldwide. We therefore set out to assess the frequency of neonatal thrombocytopenia associated or not with bacterial infection in the NICU. We conducted a retrospective and prospective study with the DPH NICU, over 10 months (August 2018 and April 2019). Thrombocytopenia encountered in the NICUs, were the subject of research into bacteriological, inflammatory, and epidemiological parameters using Inlog laboratory data processing software. During this period, 1280 babies were hospitalized, 94 of whom underwent thrombocytopenia, corresponding to 7.34%, with a sex ratio of 0.92. The number of babies presenting with thrombocytopenia during the first week of hospitalization was 72, accounting for 76.6%. The clinical context was usually low birth weight in 30.8% of cases and perinatal asphyxia (25%). Thrombocytopenia ranged from 2000 to 137,000 with an average of 69,520/mm3. Among these thrombocytopenias, 64 cases (68%) were below 100,000 mm3 and 44 cases had a CRP >5 mg/l. A total of 30 bacteria were isolated, including 23 Enterobacteria, 2 Streptococci, and 1 Acinetobacter. Among these enterobacteria, 14 were multidrug-resistant (MDR). Thrombocytopenia associated with a multidrug-resistant bacterial infection is a real challenging management.

Review of varicella-zoster virus infections in pregnant women and neonates

Even though varicella is rare in pregnancy, the disease can lead occasionally to disastrous illnesses for both the mother and her neonate. By contrast, normal zoster is not associated with special problems during pregnancy and peri- natal period. Pregnant women, who contract varicella, are at risk of varicella pneumonia which must be regarded as medical emergency. At any stage during pregnancy, chickenpox may cause intrauterine infection. The consequences for the fetus depend on the time of maternal disease. During the first two trimesters, maternal varicella may result in congenital varicella syndrome which may occur in nearly 2%. Typical symptoms are skin lesions in dermatomal distribution, neurological defects, eye diseases, and skeletal anomalies. Maternal infection near term is associated with a substantial risk of intrauterine acquired neonatal chickenpox in the neonate. If the mother develops varicella rash between day 4 (5) ante partum and day 2 post partum, generalized neonatal varicella leading to death in about 20% of the cases has to be expected. The present paper reviews the clinical consequences and the currently available concepts of prevention, diagnosis, and therapy of varicella-zoster virus infections during pregnancy.

Microbiology laboratory and the management of motherchild varicella-zoster virus infection

Varicella-zoster virus, which is responsible for varicella(chickenpox) and herpes zoster(shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella(particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times:(1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection;(2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear(atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation;(3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and(4) when the baby is born and it is necessary to confirm a diagnosis of varicella(and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn.

Study on the Relationship between Nursing Staffing and Nosocomial Infection in Very Low Birth Weight Infants

Background: At present, there is no domestic research on the relationship between nurse staffing and hospital infection in very low birth weight infants. In this paper, we will explore the relationship between nurses of very low birth weight (VLBW) infants in neonatal intensive care unit (NICU) and nosocomial infections. Methods: The clinical data of 280 very low birth weight infants born in our hospital from January 2010 to January 2020 were collected, and the chi-square test and multiple logistic regression analysis were used to study the nursing staff of each very low birth weight infant who was admitted to the NICU The relationship between the number of infections and hospital infections. Results: On average, each nurse needs to care for 4.3 very low birth weight infants (lowest to highest: 2.50 - 8.42). In the univariate analysis, the higher the incidence of urinary tract infection (P < 0.05), the multivariate logistic regression analysis of neonatal nosocomial infection showed that nurse staffing was significantly related to the incidence of urinary tract infection (OR = 1.78;95% confidence interval, 1.17 - 2.35, P < 0.05). However, there was no significant correlation between nurse staffing and bloodstream infection (OR = 0.91;95% confidence interval, 0.74 - 1.06, P > 0.05) or Ventilator associated pneumonia (VAP) infection (OR = 1.17;95% confidence interval, 0.94 - 1.47, P > 0.05). Conclusion: Our research shows that in the neonatal intensive care unit, the reasonable deployment of nursing staff is an important factor in preventing urinary tract infections in very low birth weight infants. It is important for improving the survival rate of very low birth weight infants and reducing the occurrence of sequelae.

Retrospective Epidemiological Investigation on Nosocomial Neonatal Sepsis in Shaanxi Province (2008-2010)

Objective: This study assessed the incidence, mortality, and pathogens associated with nosocomial neonatal sepsis (NNS) in Shaanxi Province to improve the prevention and control of NNS. Methods: Nine large neonatal departments in Shaanxi Province participated in this retrospective epidemiological investigation of NNS during the period of 2008-2010, using standardized protocol. The incidence, mortality, pathogens, antibiotic sensitivity, clinical characteristics, prognosis, and costs were analyzed. Results: Of 16,642 neonates admitted to neonatal departments in the 9 hospitals during 2008-2010, there were 139 cases of NNS, with incidence of 8.3% and mortality of 20.8%. The predominant pathogens were Gram-negative bacteria, accounting for 67.6% of positive cultures. Gram-positive bacteria accounted for 24.5% and fungal infection accounted for 7.9%. The most common Gram-negative species were Klebsiella pneumonia (22.3%), Escherichia coli (15.1%), and Enterobacter cloacae (8.6%). The dominant Gram-positive species identified were coagulase negative staphylococcal species (CONS) (8.6%), followed by Staphylococcus aureus (7.9%). The recovered bacterial pathogens demonstrated varying antibiotic resistance, but no meropenem-or-vancomycin-resistant strains were detected. Preterm and full-term infants showed significant difference in clinical manifestations, laboratory findings, mortality, and cost. Conclusion: NNS in the hospitals of Shaanxi Province showed a decreasing trend from 2008 to 2010, but the mortality did not reduce significantly. The predominant bacteria were Gram negative, and pathogens were found to have varying antibiotic resistance. The preterm group had higher mortality and costs than the full-term infants. Therefore, effective measures should be taken to control NNS, especially in preterm infants.

Plasma D-dimer level in early and late-onset neonatal sepsis

BACKGROUND Neonatal sepsis is a life-threatening disease.Early diagnosis is essential,but no single marker of infection has been identified.Sepsis activates a coagulation cascade with simultaneous production of the D-dimers due to lysis of fibrin.Ddimer test reflects the activation of the coagulation system.AIM To assess the D-dimer plasma level,elaborating its clinicopathological value in neonates with early-onset and late-onset neonatal sepsis.METHODS The study was a prospective cross-sectional study that included ninety neonates;divided into three groups:Group I:Early-onset sepsis(EOS);Group II:Late-onset sepsis(LOS);and GroupⅢ:Control group.We diagnosed neonatal sepsis according to our protocol.C-reactive protein(CRP)and D-dimer assays were compared between EOS and LOS and correlated to the causative microbiological agents.RESULTS D-dimer was significantly higher in septic groups with a considerably higher number of cases with positive D-dimer.Neonates with LOS had substantially higher levels of D-dimer than EOS,with no significant differences in CRP.Neonates with LOS had a significantly longer hospitalization duration and higher gram-negative bacteriemia and mortality rates than EOS(P<0.01).Gramnegative bacteria have the highest D-dimer levels(Acinetobacter,Klebsiella,and Pseudomonas)and CRP(Serratia,Klebsiella,and Pseudomonas);while gram-positive sepsis was associated with relatively lower levels.D-dimer had a significant negative correlation with hemoglobin level and platelet count;and a significant positive correlation with CRP,hospitalization duration,and mortality rates.The best-suggested cut-off point for D-dimer in neonatal sepsis was 0.75 mg/L,giving a sensitivity of 72.7%and specificity of 86.7%.The D-dimer assay has specificity and sensitivity comparable to CRP in the current study.CONCLUSION The current study revealed a significant diagnostic value for D-dimer in neonatal sepsis.D-dimer can be used as an adjunct to other sepsis markers to increase the sensitivity and specificity of diagnosing neonatal sepsis.

Uropathogens of Urinary Tract Infection in Pregnancy and Maternal-Fetal Outcomes at the Douala Referral Hospital, Cameroon: A Case-Control Study

Background: Urinary tract infection (UTI) is common in pregnancy and accounts for a high burden of maternal and perinatal morbidity/mortality and health expenditure. The burden of this condition has been understudied in Cameroon. We aimed to determine the uropathogens of urinary tract infection in pregnancy, and the maternal-fetal outcomes of UTI at the Douala Referral Hospital. Methods: We conducted an analytic matched case-control study of 206 pregnant women with evidence of urinary tract infection (103 cases) and those without (103 controls) who underwent antenatal care and gave birth at the DRH from January 2019 to April 2019. Socio-demographic, laboratory and maternal-fetal outcome data were collected using a pre-tested structured questionnaire and analyzed with SPSS version 23. Statistical significance was set at p < 0.05. Results: Escherichia coli (51.5%), Proteus mirabilis (15.5%), Staphylococcus aureus (11.7%) and Klebsiella sp. (6.8%) were the predominant uropathogens of UTI. Maternal outcomes of UTI were puerperal pyelonephritis (AOR 3.1;95% CI: 1.11 - 3.55, p = 0.0023), preterm labor (AOR 4.4;95% CI: 1.0 - 2.7, p = 0.008) and preterm birth (AOR 4.6;95% CI 1.9 - 22.9, p = 0.05). Furthermore, low birth weight (AOR 2.1;95% CI: 0.8 - 5.6, p = 0.05), neonatal infection (AOR 13;95% CI: 0.9 - 191.6, p = 0.04) and neonatal intensive care unit admission (AOR 2.5;95% CI: 1.7 - 3.6, p = 0.003) were fetal outcomes of UTI. Conclusion: Escherichia coli was the main uropathogenic agent of UTI during pregnancy. Maternal outcomes of UTI were puerperal pyelonephritis, preterm labor and delivery while fetal outcomes include: low-birth weight, neonatal infection and neonatal intensive care admission. Prompt diagnosis of this condition is the cornerstone to avoid adverse outcomes.

Antibiotic sensitivity pattern of common bacterial pathogens in NICU and neonatal ward in Hamedan province of Iran

Bacterial pathogens and drug resistance are different in hospitals of each country. In this study we determined bacterial path- ogens and drug sensitivity in the neonatal ward and neonatal intensive care unit (NICU) in Ekbatan hospital in Hamedan. This cross-sectional descriptive study was done on 1150 hospitalized neonates in neonatal and NICU wards of Ekbatan hospital of the Hamadan university of medical sciences from September 2004 to September 2006. Blood, cerebrospinal fluid (CSF), urine, stool, eye excretion, synovial fluid, umbilical secretion and ascitic fluid were evaluated. Positive cultures were evaluated for antibiotic resistance with disk diffusion test methed. All of the data in questionnaires was analyzed with SPSS 13. Cultures including blood, urine, CSF , stool, eye excretion, synovial fluid, umbilical secretion and ascitic fluid was done in 417 neonates (833 cultures). These cultures were including: urine, 323 cases (38.8%) blood 293 cases (35.2%), CSF 180 cases (21.6%) , stool 17 cases (2%), eye secretion 16 cases (1.9%) and other secretions (synovial, umbilical, etc) 4 cases (0.5%). The cultures were positive in 105 cases (25.2%). 60 male neonates (57.1%) and 45 female neonates (42.9%) were culture positive. The most common microorganisms were E coli 66.7% (70 cases), Klebsiella 10.5% (11 cases). Drug resistance was high in these microorganisms. The most common microorganisms were Ecoli and klebsiella. Drug resistance was high in the isolated microorganisms.

Infections Related to Health Care in Newborns: Documental Study Based on Analysis of Research Database

This documentary research aimed to describe the results of an epidemiological survey that sought to determine the prevalence of Infections Related to Health Care (IRHC) in newborns admitted to a Neonatal Intensive Care Unit (NICU) at the city of Rio de Janeiro. For methodology, the existing data in the original research database were used as the primary source. The method used was the case study in a quantitative approach. The data have been statistically arranged by odds ratio, which measured the possibility of IRHC development at the 102 newborns, by exposition at the risk factors. Results: IRHC prevalence with pneumonias, sepsis, navel’s infection and ocular infections predominance rises. Prematures are 4.10 more susceptible. Twelve hours after amniotic rupture there are 1.77 more chances of infections. Babies with more than 10 days of hospitalization are 4.70 more susceptible than those with 10 days. The registers examined were incipient at the IRHC’s characterization, beginning and duration, which make the IRHC’s diagnostic/notification difficult.