Background: Bronchoalveolar lavage (BAL) is a standardized method to obtain specimen samples from the airway lumen of the respiratory system. BAL is used to diagnose lung infection and infection markers in neonates.
Objectives:The aim was to evaluate the utility of flexible fiberoptic bronchoscopy in term and preterm neonates and to evaluate the use of BAL obtained by bronchoscopy in neonatal lung disease. Methods: A retrospective analysis of Neonatal Intensive Care Unit (NICU) babies, during a 7-year period was conducted on 599 neonates who underwent the BAL procedure. Characteristics of the patients, indications, complications, and results of the procedure were recorded. Results: The main indications were nosocomial pneumonia (140) and unilateral lung disease (74). A normal finding was most prevalent (201), followed by tracheitis (65). Microbiology on BAL fluid was positive in 33% of bronchoscopies (195/599); most common organisms isolated were Acinetobacter, Klebsiella, and Pseudomonas. Conclusions: Neonatal bronchoscopy can serve as an important diagnostic and therapeutic tool in the management of neonatal lung disease, BAL specimen microbiology from bronchoscopy directs clinical decision making in the management of neonatal lung infection. Individual common markers of infection have poor correlation to BAL. A combination of the markers, however, improves correlation with
Raoultella ornitholytica, an environmental organism, has only recently been reported as a cause of infections in humans, and is associated mainly with bacteraemia in elderly patients. Carbapenem resistance is unusual in Raoultella spp. We describe the first paediatric case of blaNDM-1 Raoultella ornitholytica bacteraemia in a preterm neonate that developed three days after hospitalisation. This case report discusses a rare organism that had an unexpected susceptibility profile and caused bacteraemia in a neonate. Treatment options are explored.
Raoultella ornitholytica, an environmental organism, has only recently been reported as a cause of infections in humans, and is associated mainly with bacteraemia in elderly patients. Carbapenem resistance is unusual in Raoultella spp. We describe the first paediatric case of bla NDM-1 Raoultella ornitholytica bacteraemia in a preterm neonate that developed three days after hospitalisation. This case report discusses a rare organism that had an unexpected susceptibility profile and caused bacteraemia in a neonate. Treatment options are explored.
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