Gram negative organisms and viral infections in neonatal sepsis

Tan, Li En

doi:10.1136/bmj.m4248

Cited by 6 publications

(5 citation statements)

References 2 publications

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“…A study has shown that Lactobacillus reduces blood LPS levels by consolidating the intestinal barrier, diminishing LPS levels in feces, and repressing lipid absorption ( 39 ). Recently, epidemiologists have noticed that the high occurrence of late-onset sepsis is usually attributed to aerobic Gram-negative rods, in particular Escherichia coli , which are more likely to cause neonatal death than staphylococcal sepsis ( 40 ). In the Inhibitor7 group, the proportions of Burkholderia and Streptococcus were higher than those in the three other groups.…”

Section: Discussionmentioning

confidence: 99%

Calcium-sensing receptor alleviates gut damage caused by endotoxemia by regulating gut microbiota

Sun,

Song,

Liu

et al. 2023

Transl Pediatr

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Background Growing evidence points to an association between the gut microbiota and neonatal diseases. Calcium-sensing receptor (CaSR) is a major modulator of tissue responses associated with calcium homeostasis and is highly expressed in the mammalian gut. CaSR may affect the composition and balance of the intestinal microenvironment. Methods Neonatal rats were randomized to the control, lipopolysaccharide (LPS), CaSR agonist, and CaSR inhibitor groups. The intestinal contents of neonatal rats were collected within 24 hours or 7 days after intervention. Then, 16S rRNA short amplicon sequencing was used to analyze biological information and the richness and diversity of individual taxa. Results LPS aggravated intestinal injury. The CaSR agonist alleviated injury, and the inhibitor further enhance intestinal injury. Activation of CaSR enhanced the diversity of the gut microbiota and the abundance of Lactobacillus . The lowest abundance of Firmicutes and the highest abundance of Bacteroidetes were found in the agonist group. CaSR impacted the bacterial species in rats with endotoxemia, and Akkermansia had the greatest effect on the differences among groups. Conclusions Activation of CaSRs could enhance the species richness and β-diversity of the gut microbiota and alter the abundance of many taxa. This could attenuate LPS-induced gut injury by modulating the gut microbiota.

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Section: Discussionmentioning

confidence: 99%

Calcium-sensing receptor alleviates gut damage caused by endotoxemia by regulating gut microbiota

Sun,

Song,

Liu

et al. 2023

Transl Pediatr

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“…Hospital-derived coagulasenegative staphylococci with various resistance mechanisms are the most frequent etiological factors causing LOS [15,16]. Recently, however, epidemiologists have observed an alarming occurrence: LOS is often caused by aerobic Gram-negative rods, particularly Escherichia coli, which are more often responsible for the death of newborns in comparison to staphylococcal sepsis [4,17].…”

Section: Discussionmentioning

confidence: 99%

The Multi-Component Causes of Late Neonatal Sepsis—Can We Regulate Them?

Pilarczyk-Zurek

Majka

Skowron³

et al. 2022

Nutrients

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Elucidating the mechanisms of bacterial translocation is crucial for the prevention and treatment of neonatal sepsis. In the present study, we aimed to evaluate the potential of lactoferrin to inhibit the development of late-onset blood infection in neonates. Our investigation evaluates the role of key stress factors leading to the translocation of intestinal bacteria into the bloodstream and, consequently, the development of life-threatening sepsis. Three stress factors, namely weaning, intraperitoneal administration of Gram-positive cocci and oral intake of Gram-negative rods, were found to act synergistically. We developed a novel model of rat pups sepsis induced by bacterial translocation and observed the inhibition of this process by supplementation of various forms of lactoferrin: iron-depleted (apolactoferrin), iron-saturated (hololactoferrin) and manganese-saturated lactoferrin. Additionally, lactoferrin saturated with manganese significantly increases the Lactobacillus bacterial population, which contributes to the fortification of the intestinal barrier and inhibits the translocation phenomenon. The acquired knowledge can be used to limit the development of sepsis in newborns in hospital neonatal intensive care units.

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“…Statistics show 2,824 cases of sepsis per 100,000 live births. Septic shock, the most critical stage of sepsis progression, requires vasopressor for blood pressure maintenance despite adequate uid resuscitation, with a mortality rate of up to 40% [3][4][5]. Prompt reversal of hypotension and ensuring organ perfusion are key to improving septic shock treatment success.…”

Section: Introductionmentioning

confidence: 99%

Maximum Norepinephrine Dosage as an Priming Indicator for Vasopressin Therapy for Neonatal Septic Shock: A Retrospective Study

Zhong,

Zhang,

Lin

et al. 2024

Preprint

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Vasopressin is uesd as a second-line vasopressor for neonates with septic shock, but the optimal timing of initiation is uncertain. We hypothesized that norepinephrine (NE) dosage is associated with neonatal septic shock mortality, and can be used for determining the optimal timing of vasopressin therapy in neonates. This study explores the correlation between the maximum norepinephrinedosage (MND) and mortality in neonates with septic shock, aiming to inform the timing of vasopressin therapy in such cases. This retrospective cohort study included neonates with evidence of septic shock and those who received NE infusion. The predictive efficacy of MND for mortality was analyzed using receiver operating characteristic (ROC) curves, and its correlation was assessed via multivariate logistic regression. Pearson correlation analysis was employed to examine the relationship between MND and poor prognostic indicators. The study included 123 neonates, with 106 in the survival group and 17 in the death group. The death group had significantly lower birth weight (p=0.022), 1-min Apgar score (p=0.005), serum albumin (p＜0.001), pH value (p=0.013), and base excess (BE) (p=0.001) levels, but higher lactate (LAC) levels (p=0.009). MND demonstrated an ROC area under the curve of 0.775 (95% CI: 0.63-0.92, p＜0.001) for predicting mortality, with an optimal threshold of 0.3 µg/(kg·min), a sensitivity of 82.4%, and a specificity of 75.5%. Multivariatelogistic regression indicated that an MND > 0.3 µg/(kg·min) (OR, 64.45, 95% CI: 3.04-1364.94) significantly increased mortality risk. Spearman rank correlation showed a positive correlation between MND and LAC (r=0.252, p=0.005), vasoactive-inotropic score (VIS) (r=0.836, p＜0.001), and a negative correlation with BE (r=-0.311, p=0.001). Conclusions: MND > 0.3 µg/(kg·min) is closely associated with mortality in neonates with septic shock and can serve as a primary auxiliary tool for deciding the timing of vasopressin therapy.

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Gram negative organisms and viral infections in neonatal sepsis

Cited by 6 publications

References 2 publications

Calcium-sensing receptor alleviates gut damage caused by endotoxemia by regulating gut microbiota

Calcium-sensing receptor alleviates gut damage caused by endotoxemia by regulating gut microbiota

The Multi-Component Causes of Late Neonatal Sepsis—Can We Regulate Them?

Maximum Norepinephrine Dosage as an Priming Indicator for Vasopressin Therapy for Neonatal Septic Shock: A Retrospective Study

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