Blood Neutrophil Response to Bacterial Infection in the First Month of Life

Gregory, Jill; Hey, Edmund

doi:10.1136/adc.47.255.747

Cited by 61 publications

(15 citation statements)

References 24 publications

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“…3 babies. '2 Infection was associated with large changes in C reactive protein within a range below the detection limit of most commercially available assays.…”

Section: Discussionmentioning

confidence: 99%

Receiver operating characteristic curves for comparison of serial neutrophil band forms and C reactive protein in neonates at risk of infection.

Russell

Smyth

Cooke

1992

Archives of Disease in Childhood

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The performance of indirect indices of infection in the newborn vary because of differences in techniques, including diagnostic cut off levels. We have compared serial neutrophil band cell counts with C reactive protein measured by rate nephelometry. The 'gold standard' was a positive culture and the performance of the tests was compared by the technique of receiver operating characteristics (ROC) as well as sensitivity and specificity.A total of 172 septic screens were performed in 56 patients. The operational diagnostic cut off values were: C reactive protein >8 mg/l, inmature:total neutrophil ratio (I:T ratio) >02, and band count >5%. Compared with the sensitivity of C reactive protein (710/), I:T ratio (34%) was significantly different but band count (69%) was not. The specificity of C reactive protein (72%) was better than band count (39%) but no better than I:T ratio (73%). ROC curves were constructed for all possible diagnostic cut off values of the tests and superior performance was demonstrated for C reactive protein compared with band count and I:T ratio.We conclude that C reactive protein is a useful early indicator of infection in neonates and that ROC curves permit comprehensive and graphic comparison between tests and the calculation of optimal diagnostic cut off values.

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“…3 babies. '2 Infection was associated with large changes in C reactive protein within a range below the detection limit of most commercially available assays.…”

Section: Discussionmentioning

confidence: 99%

Receiver operating characteristic curves for comparison of serial neutrophil band forms and C reactive protein in neonates at risk of infection.

Russell

Smyth

Cooke

1992

Archives of Disease in Childhood

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“…Immunocompromised patients and infants with a neutrophil count less than the normal range (1.8 ϫ 10 9 /L) were excluded from the control group. 9 …”

Section: Studymentioning

confidence: 99%

Bactericidal Activity Against Coagulase-Negative Staphylococci Is Impaired in Infants Receiving Long-Term Parenteral Nutrition

Okada

Klein²,

Saene³

et al. 2000

Annals of Surgery

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ObjectiveTo examine the role of total parenteral nutrition (TPN) in predisposing infants to infection caused by coagulase-negative staphylococci. Summary Background DataTotal parenteral nutrition is an important means of providing essential nutrients to newborn infants. However, its use has been associated with complications, particularly infection caused by coagulase-negative staphylococci. Recent data suggest that TPN may modulate immune function; however, reports directly indicating impaired immunity against coagulase-negative staphylococci during TPN are limited. MethodsStudy 1 involved 31 infants younger than 4 months who had undergone surgery and were not receiving antibiotics; 20 were receiving TPN and 11 were receiving a normal enteral diet. An in vitro whole blood model was used to measure the host bactericidal activity against coagulase-negative staphylococci. Bacterial killing and phagocytosis were measured after a 45-minute challenge with viable coagulase-negative staphylococci. In study 2, whole blood killing and intracellular killing of coagulase-negative staphylococci were measured in five newborn infants (younger than 2 months) who were receiving long-term TPN (Ͼ10 days), five control infants receiving a normal enteral diet, and five healthy adults. ResultsIn study 1, infants receiving a normal enteral diet showed a high capacity to ingest and kill coagulase-negative staphylococci. In contrast, the blood of infants receiving long-term TPN showed a reduction in coagulase-negative staphylococci phagocytosis and killing. There were significant negative linear correlations between the duration of TPN and killing of coagulase-negative staphylococci and phagocytosis of coagulasenegative staphylococci. In study 2, infants receiving long-term TPN had lower whole blood killing and intracellular killing than infants receiving a normal enteral diet and healthy adult volunteers. These data seem to indicate a neutrophil dysfunction mediated by TPN in infancy. ConclusionsHost defense mechanisms, including phagocytosis and killing of coagulase-negative staphylococci, are impaired during long-term TPN. The impaired bactericidal activity seems to be related to defective intracellular killing in neutrophils. These findings may explain the high rate of septicemia caused by coagulase-negative staphylococci in infants receiving TPN.Total parenteral nutrition (TPN) has contributed to the recent improvement in the care of newborn infants. However, this form of nutritional support is associated with complications, particularly infection. Five percent to 37% of infants receiving TPN become bacteremic, 1-3 most frequently with coagulase-negative staphylococci.4 Infection may result in impairment of liver function or systemic inflammatory response syndrome, necessitating the removal of central venous catheters. It therefore represents a major clinical problem of TPN in infancy.It is generally believed that infection with coagulasenegative staphylococci results from contamination of in-

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“…Evidence of bacterial infection in the form of presence of toxic granules in the peripheral blood has been advocated by various workers [9,10]. In the present series, only 26% cases of pneumonias had demonstrated toxic gran› ules.…”

Section: Observationsmentioning

confidence: 41%

Comparative Efficacy of Diagnostic Procedures in Pneumonia in Children

Vatwani¹,

Kumar²,

Sood

1995

Medical Journal Armed Forces India

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ABSTRACfVarious investigative methods used in diagnosis, in 200 children with pneumonia, were analyzed to establish the diagnostic superiority. Lung juice aspirate culture yielded 52.4% positivity and laryngeal swab culture 52%. Gastric aspirate culture was positive in 36% cases and blood culture positivity was in 10% cases only. Thus laryngeal swab culture is as effective as lung-juice aspiration culture in the isolation ofthe organisms causing lower respiratory tract infections. Gastric aspirate smear examination for polymorphonuclear leucocyte count is helpful in screening bacterial pneumonias. MJAFI 1995; 51 : 13-16

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Blood Neutrophil Response to Bacterial Infection in the First Month of Life

Cited by 61 publications

References 24 publications

Receiver operating characteristic curves for comparison of serial neutrophil band forms and C reactive protein in neonates at risk of infection.

Receiver operating characteristic curves for comparison of serial neutrophil band forms and C reactive protein in neonates at risk of infection.

Bactericidal Activity Against Coagulase-Negative Staphylococci Is Impaired in Infants Receiving Long-Term Parenteral Nutrition

Comparative Efficacy of Diagnostic Procedures in Pneumonia in Children

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