The changing spectrum of neonatal infectious disease

Plano, Lisa R. W.

doi:10.1038/jp.2010.92

Cited by 13 publications

(16 citation statements)

References 50 publications

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“…Our study confirmed these risk factors for development of EOS. As expected, vaginal delivery is significantly more frequent in our septic group infants because of the exposure of infants to microorganisms in birth canal (Plano 2010 most commonly isolated pathogens in positive blood cultures of our septic infants, and those findings are in concordance with previous studies (Plano 2010;Cortese et al 2016). TNF-α and IL-6 are primary proinflammatory cytokines that mediate the initial response of the innate immune system to infection and have an important role in the pathogenesis of sepsis.…”

Section: Discussionsupporting

confidence: 93%

Association between Tumor Necrosis Factor-<i>α</i> Promoter -308 G/A Polymorphism and Early Onset Sepsis in Preterm Infants

Varljen

Rakic²,

Sekulovic³

et al. 2019

Tohoku J. Exp. Med.

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Early-onset neonatal sepsis (EOS) is diagnosed during the first 7 days of neonatal life and is the major cause of morbidity and mortality among preterm infants. Genetic predisposition may have an impact on EOS susceptibility and outcome. The aim of our study was to explore the association between TNF-α-308 G/A or IL-6-174 G/C gene polymorphism and the susceptibility and outcome of EOS in preterm infants. The study included 471 preterm infants: 282 with EOS (151 with culture proven sepsis and 131 with clinical sepsis) and 189 without infection (control group). TNF-α-308 G/A and IL-6-174 G/C were genotyped using Real-time RCR method. We observed significantly higher frequency of A allele of TNF-α-308 G/A polymorphism in blood culture proven EOS (p = 0.017) or clinical EOS (p = 0.025) compared with the control group. Logistic regression confirmed significant association between TNF-α-308 GA+AA genotypes and development of culture proven EOS (B =-0.718, p = 0.013) or clinical EOS (B =-0.602, p = 0.027). No significant differences in IL6-174G/C alleles or genotypes distribution have been observed between culture proven EOS group, clinical EOS group and the control group. An association between TNF-α-308 G/A or IL-6-174 G/C genotypes and EOS lethal outcome was not observed (p = 0.652 and p = 0.384, respectively). According to our analysis of large cohort of preterm infants with clearly defined EOS groups, the TNF-α-308 A allele may be a risk factor for the EOS occurrence.

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Section: Discussionsupporting

confidence: 93%

Association between Tumor Necrosis Factor-<i>α</i> Promoter -308 G/A Polymorphism and Early Onset Sepsis in Preterm Infants

Varljen

Rakic²,

Sekulovic³

et al. 2019

Tohoku J. Exp. Med.

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“…Birthweight and gestational age have been shown in the literature to be the predominant patient related risk factors for healthcare-associated infections [2,19-21]. We could fully confirm these findings our study.…”

Section: Discussionsupporting

confidence: 84%

The impact of staffing on central venous catheter-associated bloodstream infections in preterm neonates – results of nation-wide cohort study in Germany

Leistner

Thürnagel

Schwab

et al. 2013

Antimicrob Resist Infect Control

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BackgroundVery low birthweight (VLBW) newborns on neonatal intensive care units (NICU) are at increased risk for developing central venous catheter-associated bloodstream infections (CVC BSI). In addition to the established intrinsic risk factors of VLBW newborns, it is still not clear which process and structure parameters within NICUs influence the prevalence of CVC BSI.MethodsThe study population consisted of VLBW newborns from NICUs that participated in the German nosocomial infection surveillance system for preterm infants (NEO-KISS) from January 2008 to June 2009. Structure and process parameters of NICUs were obtained by a questionnaire-based enquiry. Patient based date and the occurrence of BSI derived from the NEO-KISS database. The association between the requested parameters and the occurrance of CVC BSI and laboratory-confirmed BSI was analyzed by generalized estimating equations.ResultsWe analyzed data on 5,586 VLBW infants from 108 NICUs and found 954 BSI cases in 847 infants. Of all BSI cases, 414 (43%) were CVC-associated. The pooled incidence density of CVC BSI was 8.3 per 1,000 CVC days. The pooled CVC utilization ratio was 24.3 CVC-days per 100 patient days. A low realized staffing rate lead to an increased risk of CVC BSI (OR 1.47; p=0.008) and also of laboratory-confirmed CVC BSI (OR 1.78; p=0.028).ConclusionsOur findings show that low levels of realized staffing are associated with increased rates of CVC BSI on NICUs. Further studies are necessary to determine a threshold that should not be undercut.

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“…Neonates (babies in their first 28 days of life) and infants (first year of life) have a premature immune system and are a particularly vulnerable population for infectious diseases and hence resistant bacteria [8,11,17–19]. In LMIC, neonatal infection rates are 3 to 20 times higher than in high-income countries (HIC) and 40% of neonatal deaths are attributable to infectious diseases in general [11,20,21].…”

Section: Introductionmentioning

confidence: 99%

Multiple antibiotic resistance as a risk factor for mortality and prolonged hospital stay: A cohort study among neonatal intensive care patients with hospital-acquired infections caused by gram-negative bacteria in Vietnam

et al. 2019

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Background Antibiotic resistance (ABR) is an increasing burden for global health. The prevalence of ABR in Southeast Asia is among the highest worldwide, especially in relation to hospital-acquired infections (HAI) in intensive care units (ICU). However, little is known about morbidity and mortality attributable to ABR in neonates. Aim This study aimed to assess mortality and the length of hospitalization attributable to ABR in gram-negative bacteria (GNB) causing HAI in a Vietnamese neonatal ICU (NICU). Methods We conducted a prospective cohort study (n = 296) in a NICU in Hanoi, Vietnam, from March 2016 to October 2017. Patients isolated with HAI caused by GNB were included. The exposure was resistance to multiple antibiotic classes, the two outcomes were mortality and length of hospital stay (LOS). Data were analysed using two regression models, controlling for confounders and effect modifiers such as co-morbidities, time at risk, severity of illness, sex, age, and birthweight. Results The overall case fatality rate was 44.3% and the 30 days mortality rate after infection was 31.8%. For every additional resistance to an antibiotic class, the odds of a fatal outcome increased by 27% and LOS increased by 2.1 days. These results were statistically significant ( p < 0.05). Conclusion ABR was identified as a significant risk factor for adverse outcomes in neonates with HAI. These findings are generally in line with previous research in children and adults. However, heterogeneous study designs, the neglect of important confounders and varying definitions of ABR impair the validity, reliability, and comparability of results.

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The changing spectrum of neonatal infectious disease

Cited by 13 publications

References 50 publications

Association between Tumor Necrosis Factor-<i>α</i> Promoter -308 G/A Polymorphism and Early Onset Sepsis in Preterm Infants

Association between Tumor Necrosis Factor-<i>α</i> Promoter -308 G/A Polymorphism and Early Onset Sepsis in Preterm Infants

The impact of staffing on central venous catheter-associated bloodstream infections in preterm neonates – results of nation-wide cohort study in Germany

Multiple antibiotic resistance as a risk factor for mortality and prolonged hospital stay: A cohort study among neonatal intensive care patients with hospital-acquired infections caused by gram-negative bacteria in Vietnam

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