جستجوی مقالات مرتبط با کلیدواژه « سپسیس نوزادی » در نشریات گروه « پزشکی »

With the increase in the number of premature neonates, there are concerns about the complications of this group. One of the common complications of preterm neonates is fungal sepsis. Therefore, this study was conducted to evaluate the efficacy of intravenous fluconazole on fungal sepsis and other complications related to premature newborns under 1200 g in a neonatal intensive care unit. The study was conducted by field trial. The intervention included intravenous injection of fluconazole (3 mg/kg, twice per week for 6 weeks) in neonates weighing less than 1200 gr in the Izadi Hospital in Qom, Iran. The intervention was conducted on September 2016 in entire population of the study. The control group was retrospective and from neonates admitted to Izadi Hospital, which were hospitalized before intervention. The outcomes (such as the need for amphotericin injection, death, fungal sepsis, time taken to reach enteral feeding and length of stay) were compared between the two groups. There was no significant difference between the two groups regarding their sex ratio (P=0.139), gestational age (P=0.834), type of delivery (P=0.841) and birth weight (P=0.458). After the intervention, fungal sepsis (from 65% to 48.3%) and the need for amphotericin injection (from 27.1% to 5%) were significantly reduced, and the mortality rate decreased from 40% to 28.3%, but this decline was not statistically significant (P=0.178). After the intervention, the length of stay in hospital (P=0.142) and neonatal intensive care unit (P=0.422), time to reach the weight of 1500 gr (P=0.717), and time taken to reach enteral feeding (P=0.289) did not change significantly. Proportion of pneumothorax, apnea, necrotizing enterocolitis, retinopathy of prematurity and need for respiratory support did not change significantly. The present study showed that administration of venous fluconazole could reduce fungal sepsis in neonates weighing less than 1200 grams in the intensive care unit. However, this study failed to demonstrate the effect of fluconazole on death, pneumothorax, apnea and need for respiratory support.

Sepsis is one of the serious infectious diseases in the neonates and infants that is potentially life threatening. The aim of the current study was to identify coagulase negative Staphylococcus and their antibiotic resistance patterns in Neonatal Sepsis in the neonates and infants hospitalized at Ghrazi Hospital, Sirjan.
In the cross-sectional study, 140 blood samples were obtained from neonates and infants hospitalized in a period of time from June to November 2015 in the Sirjan, Kerman and then evaluated based on many items such as: BC(blood culture)/sex/age/admission date/weight/type of birth/admission ward/clinical findings/predisposing factors. All of these informations were acquired from patients profile. All of the isolated S. epidermidis strains were confirmed by PCR. Antibiotic susceptibility test was performed by disk diffusion method.
of 140 blood samples, 10 CoNS strains were isolated. Evaluation of EDTA tube and molecular identification confirmed that 6 isolates were S. epidermidis. The results of disk diffusion test showed that most of them were susceptible to vancomycin and novobiocin and the most of them were resistance to cefixime, ceftriaxone and Cephalexin. In the work, half of strains (50%) were resistance to oxacillin. So, they were methicillin resistance S. epidermidis (MRSE).
Coagulase negative Staphylococcus (S. epidermidis) is most common cause of sepsis. The specificity and sensitivity of PCR for detection of this strains in the emergency condition was useful.

Neonatal Sepsis is the most important disease in the first 28 days of life which is diagnosed definitely using the blood culture. The C-reactive protein test (CRP) is a simple method for the early diagnosis of sepsis, which is not so used. This study was conducted to determine the diagnostic value of this method in sepsis.
This cross-sectional study was performed on 100 newborns that were suspected of sepsis in Shahrood hospitals. Their quality CRP was measured using sepsis routine tests in the first 6, 24, and 48 hours of admission. The CRP≥1was considered as positive CRP.
Most of the certain sepsis cases were among the new borns who were heavier than 2500 g (p This study showed that the serumal CRP levels can be used as a quick and sensitive test, to approve or disapprove the certain sepsis especially in the first 24 to 48 hours of neonatal sepsis occurrence.

The signs and symptoms of neonatal sepsis are often non-specific and can make the diagnosis of infection more difficult. This leads to treat majority of neonates with antibiotics without bacterial infections. The aim of this study was to determine the incidence of positive bacterial cultures and isolating the etiologic agents from neonates with suspected sepsis. This cross-sectional study was conducted on 120 neonates with suspected bacterial sepsis admitted in Mahdieh hospital, Tehran, Iran. Blood culture was performed by BACTEC 9120 system, as a more sensitive method compared to current blood culture techniques. Sepsis was classified as definite, probable, or possible based on clinical findings of sepsis, hematologic data, blood culture and CRP. Among 120 neonates, 11 cases had positive blood culture. Seven of them were positive by staphylococcus epidermidis and the rest by entrococcus, lactobacillus, diphtheroid and gram positive bacillus. Definite, probable, and possible sepsis was found in 1.7%, 9.2% and 89.1% of neonates, respectively. Early onset sepsis was determined in 90.8% of patients. The most common clinical manifestations were respiratory distress and apnea. It is beneficial to use an automated blood culture system such as BACTEC which is a sensitive method and lead to earlier detection of bacterial growth.

Premature rupture of membranes (PROM) increases the rate of neonatal sepsis. Using a clinical guideline for initiating the laboratory evaluation and treatment of such neonates, for instance PROM-Scoring system, particularely in developing countries in which the availability of rapid and accurate clinical conveniences are limited, may surprisingly result in reducing the antibiotic consumption, hospital charges and neonatal morbidity. We performed this survey to outline these issues. In this cross-sectional study 270 newborns of whom were born 18 hours or more after PROM were enrolled and studied at Mahdieh hospital for a one year period. The neonates underwent a thorough evaluation and the symptomatic ones were treated for sepsis, whereas the asymptomatc newborns and the ones with a PROM score of less than 3 went under a in-hospital supervision for 3 days. Among the studied newborn, 79 cases were symptomatic and 199 were symptom free. The threshold score of 3 was of an accurate specificity (100%) in diagnosing the affected infants. All the asymptomatic ones have a score below 3. Five cases developed several symptoms mostly during their first 12 hours of lives whom were considered as having sepsis and, therefore, were assessed and treated. None of asymptomatic cases were referred again after their discharge thus far. 14 neonates (5.2%) who all weighed less than 2500gr, died due to either RDS, Asphyxia or congenital anomalies. Based on the achieved results we suggest all the symptomatic newborns and the asymptomatic ones with PROM score of above 3 to be precisely evaluated and consequently treated for sepsis, whereas for asymptomatic infants with a score of less than 3 a 24-72 hours of in-hospital supervision is sufficient.

Early diagnosis of neonatal sepsis is essential for successful treatment. Blood culture is a gold standard for diagnosis but the final results are not available until 48-72 hours after culture. Interleukin-6 (IL-6) as a marker plays a critical role in the induction of C-reactive protein (CRP) synthesis in the liver. It has been hypothesized that this cytokine could be detected in blood earlier than CRP during the course of neonatal sepsis. Blood samples were collected upon admission from 50 neonates with suspected sepsis, and 10 healthy neonates. The patients were assigned to two groups according to bacteriological and laboratory results. Group І consisted of 19 newborns with positive blood cultures and clinical signs of sepsis. Group ІІ included 31 neonates with negative blood cultures, but with two or three clinical signs of sepsis. The control group (group III) included 10 healthy neonates with no clinical or biological data of infection. Serum CRP was determined by using the nephelometry method and IL-6 was determined by ELISA method. Mean CRP level in the group with proven sepsis was 22.18 mg/l which was higher than in other groups (P=0.005). The sensitivity and specificity of CRP were 57% and 100%, respectively. Mean level of IL-6 was 117.49 pg/ml in group І, which was higher than in other groups (P=0.001), exhibiting a sensitivity of 78% and a specificity of 95%. Based on our results, measurement of IL-6 is more useful than CRP for early diagnosis of neonatal sepsis, especially within the 24 hours before the onset of sepsis. We conclude that IL-6 measurement combined with CRP measurement can be the ideal tests for diagnosis of neonatal sepsis.