No abstract

No abstract

A total of 801 bacteria were isolated from 784 neonates over 6 years-599 isolates from blood and 202 from cerebrospinal fluid. Overall, 54% of bacteria were gram-positive and 46% gram-negative. The commonest causes of neonatal sepsis were group B Streptococcus (17%) and non-typhoidal Salmonella (14%). In vitro antibiotic susceptibility to the first-line antibiotic combination of penicillin and gentamicin was 78% for all isolates, but in vitro sensitivities to gentamicin for Klebsiella spp and non-typhoidal Salmonella were only 33% and 53%, respectively. In-hospital case fatality rate was known for only 301 cases and was high at 48%. Group B Streptococcus was associated with the best outcome. Mortality was significantly higher if presentation was in the 1st week of life or if sepsis was caused by gram-negative bacteria. The causes of neonatal sepsis in this population show a different pattern from other studies in developing countries.

ANZCT 12615000380594.

With full contemporary neonatal intensive care, the outcome for liveborn infants in the present cohort delivered following membrane rupture occurring before 24 weeks' gestation, of at least 14 days duration, was better than previously reported.

No abstract

No abstract

Always looking for Clinical Neurophysiology articles, one in particular 1 7 has attracted a lot of attention because the results are interesting, 8 addressing a topic of clinical relevance in a multidisciplinary interface 9 such as the SSEP amplitudes add information for prognostication in 10 postanoxic coma. 11We think the article offers a good opportunity for resident 12 physicians and specialists, to review neurophysiological features, 13 and mainly to publicize and discuss the role of the somatosensory 14 evoked potential (SSEP) in neurology. 15The authors conclude that very low cortical SSEP amplitudes are 16 predictive of poor outcome in patients after cardiac arrest. Combining 17 bilaterally absent N20 and very low SSEP amplitude increases 18 sensitivity substantially. 1 19 Others authors raise the hypothesis that the P25/30 has a radially 20 oriented generator and is less influenced by the electrode position and 21 could decrease false positive results when compared to focusing on 22 the amplitude of the N20 alone. 2 23We partially agree with this statement, we think that the more 24 neurophysiological elements to evaluate, the better it will be, and this 25 is what makes the assessment of multimodal evoked potentials, SSEP 26 and auditory evoked potentials, more specific in cases of altered 27 consciousness. 2,3 28 The evoked potentials of short latency are, in general, useful for 29 evaluating patients in a coma, because they do not change in 30 metabolic and pharmacological states. The absence of cortical 31 responses (N20) bilaterally is a reliable sign of a poor prognosis. 32 Patients who present unilateral preservation of these responses 33 may show functional recovery. Meta-analyses of the bilateral 34 absence of cortical N20 responses, recorded after 72 h, can predict 35 death or the persistent vegetative state with a specificity of 99% in 36 anoxicÀischaemic and around 95% in traumatic coma. 4 37 SSEPs are assessed as normal, abnormal (increased latency or 38 reduced amplitude), or absent on each side. When bilaterally absent 39 or alternatively normal following trauma, SSEPs may help detect 40 patients with poor or good prognosis. For example, normal SSEPs 41 after trauma are associated with a 57% chance of good recovery, 42 whereas bilaterally absent SSEPs are associated with only a 1% 43 chance of functional recovery. In addition, repeated SSEP 44 measures may also help detect patients with brainstem herniation 45 due to interruption of these functional connections, or with cerebral 46 ischemia correlating with jugular bulb evidence of reduced oxygen 47