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Maternal Sepsis
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Sanjeewa Padumadasa, Udya Rodrigo
Prompt administration of broad-spectrum IV antibiotics, e.g. ceftriaxone, metronidazole and gentamicin, is essential to prevent both maternal and fetal complications. Neonatal sepsis is reduced by up to 80% with intrapartum antibiotic treatment. The currently used standard antibiotic regimens do not cover Ureaplasma urealyticum, which is one of the most rampant microorganisms implicated in the pathogenesis of intraamniotic infection. At the same time, specific coverage against ureaplasma (with macrolide antibiotics) has not been found to improve the outcome in intraamniotic infection. Antipyretics, e.g. paracetamol, should be administered.
Neonatal Bacterial Infection
Published in K. Balamurugan, U. Prithika, Pocket Guide to Bacterial Infections, 2019
Koilmani Emmanuvel Rajan, Christopher Karen
Neonatal sepsis is the growth of microorganism in the blood of a newborn with systemic signs of infection and hemodynamic compromise (Ganatra et al. 2010; Tosson and Speer 2011). Neonates with sepsis may progress to septic shock where the progressions of the infection have not been stopped; multiple organ damage can occur and results in death (Wynn and Wong 2010).
Use of C-Reactive Protein (CRP) and haematological score to predict positive blood cultures in sepsis
Published in Cut Adeya Adella, Stem Cell Oncology, 2018
I.N.D. Lubis, D.E.F. Liestiadi, E. Azlin, S. Nafianti
The definitive diagnosis of neonatal sepsis is made by isolating the causative pathogens, commonly from blood cultures (Gotoff, 2002). Nevertheless, bacterial growth in culture requires time and it is not always possible to isolate the causative agents (Shane & Stoll, 2014). Other commonly used diagnostic tests include total and differential White Blood Cell (WBC) count, absolute and immature neutrophil counts, the ratio of Immature-to-Total neutrophils (IT ratio), Procalcitonin (PCT) and C-Reactive Protein (CRP) (Shane et al., 2017; Stocker et al., 2010; Canpolat et al., 2011). However, the availability of some of these tests is often limited to central hospitals. Another approach is to use a Haematological Scoring System (HSS), developed to facilitate the diagnosis of neonatal sepsis (Shane et al., 2017).
Clinical value of procalcitonin-to-albumin ratio for identifying sepsis in neonates with pneumonia
Published in Annals of Medicine, 2023
Tiewei Li, Xiaojuan Li, Zhiwei Zhu, Xinrui Liu, Geng Dong, Zhe Xu, Min Zhang, Ying Zhou, Jianwei Yang, Junmei Yang, Panpan Fang, Xiaoliang Qiao
The neonate’s lung is susceptible to microorganisms infection, which can lead to pneumonia [1,2]. Neonatal pneumonia is infectious lung disease with high morbidity and mortality worldwide [3,4]. The onset of neonatal pneumonia may be within hours of birth and part of a generalized sepsis syndrome. Neonatal sepsis is a severe bloodstream infection associated with a systemic inflammatory response and life-threatening organ system dysfunction [5]. Early recognition of sepsis and early treatment is encouraged by the Surviving Sepsis Campaign Physician’s management guidelines [6]. Recently, blood culture tests are the gold standard for diagnosing neonatal sepsis [7]. However, blood culture tests have a 48–72 h reporting delay and a low positive detection rate of pathogenic microorganisms [7]. Therefore, finding new biomarkers to distinguish sepsis from pneumonia in neonates is critical.
Clinical assessment of neutrophil gelatinase-associated lipocalin as a potential diagnostic marker for neonatal sepsis: a prospective cohort study
Published in Annals of Medicine, 2022
Dina Midan, Fady El-Gendy, Dalia Abo ELAlla, Mayada Kotb
Routine neonatal clinical sepsis diagnosis mainly depends on blood culture, serum procalcitonin, and CRP levels. However, cultures delay the diagnosis by at least 48 h, and CRP and procalcitonin have low diagnostic efficacy [3,15]. Hence we evaluated a new parameter for the early diagnosis of neonatal sepsis. Our results elicited significant difference between cases and control regarding serum creatinine and urea (p<.001) and although NGAL is a known marker of kidney injury, we assume that its rise in our cases is attributed to sepsis itself as we basically recruited cases with serum creatinine level less than 1.5 mg/dl which is the known cut-off value for AKI in neonates [16]. We also studied cases with early onset sepsis in the first few days of life where the serum level of kidney function tests is considerably related to maternal kidney function tests. In patients without inflammation, the upsurge in plasma-NGAL may be a well-grounded marker to recognize the beginning of AKI. Regarding the patients undergoing mild to moderate inflammation, the diagnostic utility of plasma-NGAL for the detection of AKI may be confined. In these conditions, a mild or moderate increase in NGAL may associate more with inflammation rather than AKI by itself [17].
Association of IL-6 -174G > C Polymorphism with Susceptibility to Childhood Sepsis: A Systematic Review and Meta-Analysis
Published in Fetal and Pediatric Pathology, 2021
Farzad Ferdosian, Mohammad Hossein Jarahzadeh, Reza Bahrami, Zahra Nafei, Mohammadali Jafari, Ali Raee-Ezzabadi, Seyed Reza Mirjalili, Hossein Neamatzadeh
To date, the pathogenesis of sepsis has not yet been fully clarified [9]. Several risk factors such as postnatal age and parity are independent risk factors for neonatal sepsis have been recognized [34]. In recent years, numerous studies have revealed an association between the IL-6 -174 G > C polymorphism and pediatric sepsis. Notwithstanding, their findings remain inconclusive and controversial. Genetic association studies are powerful tools to identify populations who are at risk for certain diseases [35]. Thus, we performed this current meta-analysis to better assess any association between the IL-6 -174G > C polymorphism and risk of sepsis in pediatrics and infants. Pooled data indicated that there was no significant association between the IL-6 -174 G > C polymorphism and risk of sepsis in pediatrics and infants. To the best of our knowledge, our pooled ORs for first time revealed that there was a significant association in the Caucasian and African populations.