Post-natal CMV infection via mother's milk in ELBW infants born to CMV seropositive mothers

Abstract

s for 2nd International Conference on Clinical Neonatology Comparison of conventional blood culture method and BacT/Alert system with respect to yield and time to positivity in neonatal sepsis Arti Maria⁎, Sumitha Phalgun, Charoo Hans, N. Dubey, Deepak Goyal PGIMER & Associated Dr RML Hospital, New Delhi, India ⁎Corresponding author. Efficient and faster ways of diagnosing neonatal sepsis than conventional blood culture are needed in clinical practice. Recently, automated systems have been developed to address this issue. We hypothesized that automated compared to conventional methods of blood culture may give better isolation performances and shorter time to yield in the diagnosis of neonatal sepsis. This was a single-center, prospective, cohort study enrolling neonates with suspected neonatal sepsis in tertiary neonatal referral unit of north India. From May 2008 to April 2009, ninety consecutive neonates with suspected sepsis were enrolled with the objective of comparing the sensitivity and the time needed to yield positivity of conventional vs. BacT/Alert blood culture. Conventional and automated cultureswere collected in standardized manner from each baby, the order being alternate in consecutive babies. Refusal to consent, being ELBW and showing hemodynamical unstability were the only exclusion criteria for the neonates screened for inclusion in the study. Statistical analysis was conducted with the SPSS software version 11.0. The results showed that positivity by BacT/Alert was 38.8% (35/90) compared to 14.4% (13/90)with conventionalmethod (p<0.05). BacT/ Alert detected 30% isolates as early as within 12 h and 100% by 48 h whereas conventional detected none before 48 h and 69.2% by 72 h (p<0.001). Staphylococcus aureus was the commonest isolated microorganism (40% of cases). We concluded that a greater yield and earlier detection of pathogens by the Bact/Alert system make it more suitable for early definitive diagnosis of neonatal sepsis. This has implications for timely rational antibiotic therapy with possible favourable outcomes in neonatal sepsis. doi:10.1016/j.earlhumdev.2010.12.021 Safety of aqueous chlorhexidine gluconate for skin antisepsis in VLBW infants Maria Grazia Capretti⁎, Marica Spinelli, Elisabetta Tridapalli, Santo Arcuri, Anna Malavolti, Emanuela Callea, Giacomo Faldella Neonatal Intensive Care Unit, St. Orsola-Malpighi General Hospital, University of Bologna, Bologna, Italy Infection Control Unit, St. Orsola-Malpighi General Hospital, University of Bologna, Bologna, Italy ⁎Corresponding author. No guidelines are available for antisepsis in infants with age <2 months. The aim of this study is to evaluate the efficacy and safety of aqueous chlorhexidine gluconate (aCG) at different concentrations for skin disinfection in VLBW (birth weight <1500 g) infants. Two different protocols for skin antisepsis were prospectively used. The rate of nosocomial infection and adverse effects were compared. In the first period (January 2007 to December 2008) we used 2%aCG solution, regardless of gestational age (GA) and birth weight (BW); in the second period (January 2009 to October 2010) 0.1%aCG was used in the first ten days of life in newborns with GA=27 weeks and/or BW=750 g and 1%aCG, in the remaining cases. Microbiological culture of CVC-tips, blood samples, urine and respiratory tract specimens were collected when infection was suspected. First period infants 15/124 vs second period infants 14/103 were found infected after 72 h of life (p=0.842); among infants with BW<750 g, 9/31were infected in the first period vs 3/21 in the second period (p=0.318). Five ELBW infants (BW<1000 g) showed burns using 2%aCG prior to insertion of umbilical venous or peripherally inserted central catheters. No burns or other adverse events were observed in the second period. Our data show that 2%aCG may not be safe when used in ELBW infants in the first days of life, suggesting that antisepsis solution in premature should be differentiated according to GA and chronologic age. doi:10.1016/j.earlhumdev.2010.12.022 Post-natal CMV infection via mother's milk in ELBW infants born to CMV seropositive mothers