PurposeTo identify the frequency of bacterial isolates in early-onset neonatal sepsis (EONS) and their antimicrobial resistance pattern.MethodsA retrospective study of EONS was conducted at the Beni Suef University Hospital from September 2008 to September 2012. A case of EONS was defined as an infant who had clinical signs of infection or who was born to a mother with risk factors for infection, and in whom blood culture obtained within 72 hours of life grew a bacterial pathogen.ResultsOf 673 neonates screened, there were 138 positive blood cultures (20.5%) (confirmed EONS). Of the recovered isolates, 86.2% were gram-negative pathogens. Klebsiella pneumoniae (42.8%), Enterobacter cloacae (22.5%), and Escherichia coli (13.8%) were the commonest isolated organisms. The most common gram-positive microorganism was Staphylococcus aureus accounting for only 12 isolates (8.7%). All Klebsiella isolates and 93% of Enterobacter isolates were resistant to ampicillin. Gram-negative pathogens had the maximum overall sensitivity to imipenem, cefepime, and ciprofloxacin; whereas, gram-positive isolates were most susceptible to vancomycin, imipenem, and piperacillin.ConclusionK. pneumoniae was the predominant causative bacteria of EONS followed by E. cloacae and E. coli. There was a high resistance to ampicillin. Imipenem had the maximum overall activity against the causative bacteria. Continuous surveillance is needed to monitor the changing epidemiology of pathogens and antibiotic sensitivity.

Skin disorders are frequent in Egyptian children with thalassemia major. Careful skin examination is required to provide early diagnosis.

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BackgroundThe β-Thalassemia syndromes are the most common hereditary chronic hemolytic anemia due to impaired globin chain synthesis. Vascular endothelial growth factor (VEGF) plays several roles in angiogenesis which is a crucial process in the pathogenesis of several inflammatory, autoimmune and malignant diseases. Endothelial damage and inflammation make a significant contribution to the pathophysiology of β-thalassemia.Purpose: The aim of the study was to assess serum VEGF level in children with beta-thalassemia major as a marker of angiogenesis.MethodsA total of 50 children entered the study, 40 patients with thalassemia major and 10 healthy controls. We used enzyme-linked immunosorbent assay for quantitative evaluation of VEGF.ResultsVEGF level was significantly higher in patients with β-thalassemia major than healthy controls (p=0.001). VEGF level was also higher in splenectomised thalassemic patients than non splenectomised ones (p=0.001). There were a positive correlation between VEGF and chelation starting age (p=0.008), and a negative correlation between VEGF and frequency of blood transfusion (p=0.002).ConclusionThalassemia patients, especially splenectomized, have elevated serum levels of VEGF. Early chelation and regular blood transfusion help to decrease serum VEGF and the risk of angiogenesis.

PurposeSepsis is a major cause of neonatal morbidity and mortality. Early diagnosis is a major problem because of the lack of specific clinical signs. Therefore, a reliable diagnostic marker is needed to guide the use of antimicrobial agents. The objective of our study was to assess the value of proadrenomedullin (pro-ADM) in establishing the diagnosis and evaluating the prognosis of neonatal sepsis.MethodsThis study enrolled 60 newborn infants with sepsis proven with positive blood cultures and 30 healthy neonates. Complete blood count, C-reactive protein levels, and pro-ADM levels were obtained from all neonates.ResultsThe pro-ADM levels were significantly higher (14.39±0.75 nmol/L) in the sepsis group than in the control group (3.12±0.23 nmol/L). The optimal cutoff value for pro-ADM was 4.3 nmol/L, with a sensitivity of 93.3% and a specificity of 86.7%. The pro-ADM levels were also higher in nonsurvivors (P=0.001).ConclusionPro-ADM can be used as a reliable biomarker for neonatal sepsis. High pro-ADM levels were associated with mortality and could be an early indicator of disease outcome.