Background. Sepsis is an important cause of mortality in newborns. However, a single reliable marker is not available for the diagnosis of neonatal late-onset sepsis (NLS). The aim of this study is to evaluate the value of serum amyloid A (SAA) and procalcitonin (PCT) in the diagnosis and follow-up of NLS. Methods. 36 septic and healthy newborns were included in the study. However, SAA, PCT, TNF-α, IL-1β, and CRP were serially measured on days 0, 4, and 8 in the patients and once in the controls. Töllner's sepsis score (TSS) was calculated for each patient. Results. CRP, PCT, and TNF-α levels in septic neonates at each study day were significantly higher than in the controls (P = .001). SAA and IL-1β levels did not differ from healthy neonates. The sensitivity and specificity were 86.8% and 97.2% for PCT, 83.3% and 80.6% for TNF-α, 75% and 44.4% for SAA on day 0. Conclusion. Present study suggests that CRP seems to be the most helpful indicator and PCT and TNF-α may be useful markers for the early diagnosis of NLS. However, SAA, IL-1β, and TSS are not reliable markers for the diagnosis and follow-up of NLS.

Objective Herein, we measured the concentration of insulinlike growth factor I (IGF-I), IGF-II, leptin, adiponectin, ghrelin, resistin, and visfatin in the umbilical cord blood of newborns categorized as “small for gestational age” (SGA), “appropriate for gestational age” (AGA), and “large for gestational age” (LGA). Our aim was to elucidate the link between the levels of these proteins and fetal growth. Study Design A total of 96 term infants were included and categorized into three weight categories. Their venous cord blood samples were collected to measure the levels of IGF-I, IGF-II, leptin, adiponectin, ghrelin, resistin, and visfatin. Results IGF-I, visfatin, and leptin levels showed significant differences among the groups. Pairwise comparisons showed that adiponectin (p = 0.023), resistin (p = 0.025), and ghrelin (p = 0.005) levels were significantly lower in the SGA group than in the LGA group. Correlation analyses showed a strong association of IGF-1, IGF-II, and leptin levels with birth weight (r = 0.644, p < 0.001; r = 0.441, p < 0.001; and r = 0.404, p < 0.001, respectively). Conclusion SGA newborns showed a significantly higher visfatin concentration and lower ghrelin, leptin, resistin, and adiponectin levels than the AGA and LGA newborns did.

The increase of leptin production with increased gestational age, and the strong association with anthropometric measurements supports the opinion that leptin behaves as a fetal growth factor. Leptin in intrauterine life is in close association with insulin and glucose metabolism. Although ghrelin was at measurable levels in preterms, no association with fetal growth and glucose metabolism could be demonstrated in preterm and term infants.

Amaç: Tüm dünyada genişletilmiş spektrumlu beta laktamaz (GSBL) üreten mikroorganizmalar ile oluşan enfeksiyonlarda artış gözlenmektedir. GSBL üreten mikroorganizmaların taşıyıcılığı, ciddi enfeksiyon için zemin hazırlamaktadır. Gereç ve Yöntemler: Bu çalışmada 3. basamak sağlık hizmeti veren bir hastanede salgın olmayan bir dönemde hastanede yatan ve ya polikliniğe başvuran çocuklarda gayta örneklerinde (464 gayta örneği; 270 hastanede yatan, 194 polikliniklere başvuran çocukta) GSBL üreten E. coli ve Klebsiella spp. sıklığının ve risk faktörlerinin prospektif olarak değerlendirilmesi planlandı. Tüm gayta örnekleri, GSBL üretimi yönünden disk yöntemi ile değerlendirildi ve imipenem duyarlılığı agar dilüsyon metodu ile CLSI kılavuzuna göre değerlendirildi. Bulgular: Hastanede yatan çocukların 66'sında (%24; 25 Escherichia coli, 39 Klebsiella pneumoniae, 2 Klebsiella oxytoca), ayaktan başvuran çocukların ise 14'ünde (%7.2; 10 E. coli, 3 K. pneumoniae, 1 K. oxytoca) gayta örneklerinde GSBL üreten mikroorganizma gösterildi. Elde edilen tüm izolatlar imipenem duyarlı idi. Hastanede yatan hastalardan elde edilen izolatlarda saptanan imipenem MIC değerlerinin, poliklinik hastalarından elde edilenlere göre 3-4 dilüsyon daha yüksek olduğu görüldü. Hastanede yatan hastalarda GSBL üreten mikroorganizmaların fekal taşıyıcılığı ile yoğun bakım ünitesinde kalış, mekanik ventilasyon gereksinimi, idrar sondası, santral kateter takılması, cerrahi girişim uygulanması ve öncesinde tedavide 3. kuşak defalosporinlerin kullanılmasının ilişkili olduğu görüldü. Ayaktan poliklinikle- AbstractObjective: The isolation of extended-spectrum β-lactamase (ESBL) -producing bacteria has increased worldwide. Fecal colonization with ESBLproducing isolates is considered a prerequisite for infection. Material and Methods:We prospectively evaluated the prevalence and risk factors for fecal carriage of ESBL-producing E. coli and Klebsiella spp. in hospitalized and ambulatory children. A total of 464 fecal samples from pediatric patients (270 hospitalized and 194 ambulatory) were collected from a tertiary care center in Turkey during a non-outbreak period. All stool samples were evaluated for ESBL production by the combination disc test and for imipenem susceptibility by the CLSI agar dilution method. Results: Sixty-six (24% of total) hospitalized children (25 with Escherichia coli, 39 with Klebsiella pneumoniae and 2 with Klebsiella oxytoca) and 14 (7.2% of total) ambulatory children (10 with E. coli, 3 with K. pneumoniae and 1 with K. oxytoca) had a positive fecal sample for ESBL-producing microorganisms. All isolates were susceptible to imipenem; however, the MIC values of strains isolated from hospitalized patients were 3-4 fold higher in dilution than were those of strains isolated from ambulatory children. Univariate analyses showed that intensive care unit stay, urinary catheterization, indwelling catheterization, surgical interventions and prior 3 rd -generation cephalosporin usage were associated with ESBL positivity for the hospitalized pati...