The present study showed the level, causes, and risk factors of NNM in Jordan. It showed also that a large proportion of NNDs are preventable or possibly preventable. Providing optimal intrapartum, and immediate postpartum care is likely to result in avoidance of a large proportion of NNDs.

ObjectiveThis study was performed to investigate the safety and efficacy of oral paracetamol versus oral ibuprofen in the treatment of patent ductus arteriosus (PDA) in premature infants.MethodsPremature infants with PDA with a gestational age of ≤32 weeks or birth weight of ≤1500 g were included in this randomized study.ResultsA total of 120 premature infants fulfilled the inclusion criteria. Of these 120 infants, 34 fulfilled the treatment criteria and 22 were finally randomized. We found no significant difference in the mortality or primary closure rates between the two groups. We also found no significant difference in the short-term neonatal outcomes.ConclusionsEither oral paracetamol or oral ibuprofen can be used safely and effectively to treat PDA in premature infants.

BackgroundThere is evidence that Candida colonization contributes to increasing invasion of candidiasis in hospitalized neonates. Few studies investigated the epidemiology and risk factors of Candida colonization among hospitalized and non-hospitalized infants. This prospective study investigated the major epidemiological characteristics of Candida species colonizing oral and rectal sites of Jordanian infants.MethodsInfants aged one year or less who were examined at the pediatrics outpatient clinic or hospitalized at the Jordan University Hospital, Amman, Jordan, were included in this study. Culture swabs were collected from oral and rectal sites and inoculated on Sabouraud dextrose agar. All Candida isolates were confirmed by the Remel RapID yeast plus system, and further investigated for specific virulence factors and antifungal susceptibility MIC using E-test. Genotyping of C. albicans isolates was determined using random amplified polymorphic DNA (RAPD) analysis method.ResultsA total of 61/492 (12.4%) infants were colonized with Candida species by either their oral/rectal sites or both. Rectal colonization was significantly more detected than oral colonization (64.6% verses 35.4%), particularly among hospitalized infants aged more than one month. The pattern and rates of colonization were as follows: C. albicans was the commonest species isolated from both sites and accounted for 67.1% of all isolates, followed by C.kefyr (11.4%), each C. tropicalis and C. glabrata (8.9%) and C. parapsilosis (3.8%).A various rates of Candida isolates proved to secrete putative virulence factors in vitro; asparatyl proteinase, phospholipase and hemolysin. C. albicans were associated significantly (P < 0.05) with these enzymes than other Candida species. All Candida isolates were susceptible to amphotericin B and caspofungin, whereas 97% of Candida species isolates were susceptible to fluconazole using E-test.The genetic similarity of 53 C. albicans isolates as demonstrated by dendrogram revealed the presence of 29 genotypes, and of these one genotype accounted for 22% of the isolates.ConclusionThis study presents important epidemiological features of Candida colonization of Jordanian infants.

Over a period of 3 years' study (2012)(2013)(2014), a total of 518 faecal samples were collected and cultured to isolate Escherichia coli. Of these, 338 (65.3 %) E. coli isolates were recovered from infants, and 142/338 (42 %) were multidrug-resistant (MDR) to $3 drug classes using the antimicrobial susceptibility disc diffusion method. A total of 125/142 (88 %) of E. coli isolates were extended-spectrum b-lactamase (ESBL) producers. blaCTX-M-15 types were observed in 80/125 (64 %) of the isolates, and 60/80 (75 %) were positive for blaCTX-M-15. Out of 338 E. coli isolates, 9 (2.6 %) were positive for ST131/O25b clone and each isolate was associated with several plasmids of different sizes (1-21.2 kb). The identities of these nine isolates were confirmed by sequencing for presence of pabB (347 bp) and trpA (427 bp) genes. This study demonstrates low prevalence rate of the highly virulent E. coli ST131 clone producing blaCTX-M-15 in the intestines of Jordanian infants.

BackgroundNeonatal sepsis caused by multidrug-resistant gram-negative bacteria has been reported in different parts of the world. It is a major threat to neonatal care, carrying a high rate of morbidity and mortality. While Colistin is the treatment of choice, few studies have reported its use in neonatal patients.MethodsA retrospective descriptive study of all neonatal patients who had multidrug-resistant Acinetobacter sepsis and were treated with Colistin over a 2-year period. Patients’ charts and hospital laboratory data were reviewed.ResultsDuring the study period, 21 newborns were treated with Colistin. All had sepsis evident by positive blood culture and clinical signs of sepsis. The median gestational age and birth weight were 33 weeks (26–39) and 1700 g (700–3600), respectively. Nine (43 %) were very low birth weight infants. Eighteen (86 %) were preterm infants. Nineteen (91 %) newborns survived. No renal impairment is documented in any of our patients. Fourteen (67 %) of our patients had elevated eosinophil counts following Colistin treatment, for those patients, the average eosinophilic counts ± standard deviation before and after Colistin therapy were 149.08 ± 190.38 to 1193 ± 523.29, respectively, with a p value of less than 0.0001.ConclusionOur study showed that Colistin was both effective and safe for treating multidrug-resistant Acinetobacter neonatal sepsis. This is a retrospective study. No universal protocol was used for the patients. The factors that might affect the response or cause side effects are difficult to evaluate.