Congenital Sepsis Research Articles

Can the Nonstress Test Predict Congenital Sepsis?

The possible role of the nonstress test (NST) in the prediction of congenital sepsis in pregnancies complicated by prolonged premature rupture of the membranes (PROM) was investigated in a retrospective controlled study. Thirteen NSTs performed within 24 hours of the delivery of infants with congenital sepsis were coded, blinded, and mixed with an equal number of blinded NSTs derived from randomly selected patients matched for gestational age with PROM but without neonatal or maternal infection. Eleven of 13 infants with congenital sepsis had a reactive NST, and two had a nonreactive test. Among the controls, there were also 11 reactive and two nonreactive NSTs. The sensitivity and specificity of the NST in predicting congenital sepsis in patients with PROM were 15.4% and 84.6%, respectively. The positive predictive value and the negative predictive value were 50%. Our results suggest that the NST is not a useful tool for prediction of congenital sepsis.

A prospective survey of necrotising enterocolitis in very low birthweight infants.

Necrotising enterocolitis is the most common gastrointestinal complication of pre-term infants. In order to determine the strength of the association of hypoxia/ischaemia and infection as causative factors in necrotising enterocolitis, we evaluated all liveborn pre-term infants with a birthweight less than 1500 g and/or gestational age less than 32 weeks in The Netherlands in 1983. The factors related to hypoxia/ischaemia included: asphyxia, respiratory distress syndrome, ventilatory assistance, persistent fetal circulation, persistent ductus arteriosus, apnoea, bradycardia, exchange transfusion and peri/intraventricular haemorrhage; those related to infection were: congenital infections, pneumonia, sepsis and meningitis. Of the 1338 infants enrolled, 1187 survived for more than 24 hours and had complete data. Mean (+/- s.d.) birthweight was 1278 (+/- 297) g and mean (+/- s.d.) gestational age 30.7 (+/- 2.6) weeks. Seventy-three (6.1%) infants developed necrotising enterocolitis: 46 (63.0%) stage I disease (clinically very suspect), 11 (15.1%) stage II (pneumatosis intestinalis) and 16 (21.9%) stage III (intestinal perforation). Mean +/- s.d. birthweight of the infants with necrotising enterocolitis (1197 +/- 284 g) was lower (P less than 0.02) than in those without necrotising enterocolitis (1283 +/- 297 g). Gestational ages were comparable. Mortality in the group with necrotising enterocolitis was 21.9% versus 15.8% in the non-necrotising enterocolitis group (NS). Stepwise logistic regression analysis indicated that among those factors studied, only sepsis and birthweight were truly associated with the occurrence of necrotising enterocolitis.

Sympatho-adrenal response to hypoglycaemia in infants.

The response of the sympathoadrenal system to hypoglycaemia of different etiology was studied in seven infants, aged 10-189 days. Five infants had hyperinsulinism secondary to nesidioblastosis or to a beta-cell adenoma of the pancreas, one infant had neonatal sepsis due to staphylococcal infection and one infant congenital growth hormone (HGH) and adrenocorticotropic hormone (ACTH) deficiency. In babies with hyperinsulinism, plasma noradrenaline increased from 0.29 +/- 0.03 to 0.61 +/- 0.09 ng/ml (P less than 0.01), whereas adrenaline increased only in three, but did not change in two babies. Increases in heart rate and blood pressure paralleled these changes. In hypoglycaemia due to congenital sepsis, noradrenaline increased from 0.39 to 1.64 ng/ml and adrenaline from 0.05 to 0.86 ng/ml. This was associated with marked haemodynamic changes. In congenital HGH and ACTH deficiency, the low basal plasma levels of noradrenaline (0.12 ng/ml) and adrenaline (0.01 ng/ml) remained unchanged in response to hypoglycaemia. Heart rate and blood pressure were unaffected. The sympathoadrenal system was activated by hypoglycaemia in all infants except in congenital HGH and ACTH deficiency. In contrast to adults, noradrenaline was the preferentially released catecholamine, suggesting an involvement of noradrenaline in glucose counter regulation in infancy.

Congenital and nosocomial sepsis in infants born in a regional perinatal unit: Cause, outcome, and white blood cell response

The incidence, cause, and outcome of sepsis and the white blood cell response were studied in 6315 infants born in a regional perinatal unit. The incidence of neonatal sepsis was 6.5 per 1000 live births. Congenital sepsis (12 cases) was overwhelming, with associated maternal infection (92%), neutropenia (75%), and high rate of mortality (50%). The most common organism was Escherichia coli (58%). Gestational age and birth weight were similar in survivors and nonsurvivors. There was a strong correlation between total white blood cell count and both mature and immature neutrophil counts in survivors but this correlation decreased substantially in neonates that died. Analysis of variance indicated that the means for polymorphonuclear leukocyte and immature neutrophil counts were significantly higher in survivors. Nosocomial sepsis (38 cases) occurred in premature low birth weight infants receiving nvasive, intensive care. The most common organism was Staphylococcus epidemidis (76%). Total white blood cell, polymorphonuclear leukocyte, and immature neutrophil counts rose significantly in response to sepsis. None died. Prevention of congenital sepsis requires methods to detect early maternal-fetal infection. Providing granulocytes to neutropenic neonates with congenital sepsis might improve outcome.

Pediatric intensive care: factors that influence outcome.

Four hundred sixty-one consecutive admissions to the Pediatric Intensive Care Unit (PICU) were evaluated using the Therapeutic Intervention Scoring System (TISS). Patients requiring an increased level of care, defined as TISS points greater than or equal to 10, accounted for 75% of patient days in the ICU. Within this group, the primary reason for admission to the ICU was congenital heart disease, trauma, malignancy, respiratory failure, and sepsis. Survival was inversely related to TISS points, through TISS itself could not differentiate between survivors and nonsurvivors. The mortality rates for children who had a congenital malformation, a cardiac arrest before admission, or who developed acute failure secondary to other disease processes were significantly increased. Comparison of critically ill children and adults using TISS showed mortality rates that were similar. Assuming that the cost of intensive care is related to both seriousness of illness (assessed by TISS) and length of hospitalization, in this pediatric population the cost of hospitalization was not disproportionately high for nonsurvivors compared to survivors. Reduction in mortality rates in a PICU population will be dependent on factors largely uncontrollable buy ICU practitioners. This will come about by reduction in the numbers of congenital malformations and the prevention of childhood trauma.

Congenital sepsis, presumably listeriosis, associated with neutropenia.

Acta Pathologica Microbiologica ScandinavicaVolume 74, Issue 2 p. 223-229 CONGENITAL SEPSIS, PRESUMABLY LISTERIOSIS, ASSOCIATED WITH NEUTROPENIA I. TYGSTRUP, I. TYGSTRUP The University Institute of Pathological Anatomy (Head: Prof. G. Teilum) and the University Department of Obstetrics and Gynecology (Head: Prof. D. Trolle).Search for more papers by this authorH. E. CHRISTENSEN, H. E. CHRISTENSEN The University Institute of Pathological Anatomy (Head: Prof. G. Teilum) and the University Department of Obstetrics and Gynecology (Head: Prof. D. Trolle).Search for more papers by this authorB. SØRENSEN, B. SØRENSEN The University Institute of Pathological Anatomy (Head: Prof. G. Teilum) and the University Department of Obstetrics and Gynecology (Head: Prof. D. Trolle).Search for more papers by this authorB. ZACHAU-CHRISTIANSEN, B. ZACHAU-CHRISTIANSEN The University Institute of Pathological Anatomy (Head: Prof. G. Teilum) and the University Department of Obstetrics and Gynecology (Head: Prof. D. Trolle).Search for more papers by this author I. TYGSTRUP, I. TYGSTRUP The University Institute of Pathological Anatomy (Head: Prof. G. Teilum) and the University Department of Obstetrics and Gynecology (Head: Prof. D. Trolle).Search for more papers by this authorH. E. CHRISTENSEN, H. E. CHRISTENSEN The University Institute of Pathological Anatomy (Head: Prof. G. Teilum) and the University Department of Obstetrics and Gynecology (Head: Prof. D. Trolle).Search for more papers by this authorB. SØRENSEN, B. SØRENSEN The University Institute of Pathological Anatomy (Head: Prof. G. Teilum) and the University Department of Obstetrics and Gynecology (Head: Prof. D. Trolle).Search for more papers by this authorB. ZACHAU-CHRISTIANSEN, B. ZACHAU-CHRISTIANSEN The University Institute of Pathological Anatomy (Head: Prof. G. Teilum) and the University Department of Obstetrics and Gynecology (Head: Prof. D. Trolle).Search for more papers by this author First published: May 1968 https://doi.org/10.1111/j.1699-0463.1968.tb03474.xCitations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume74, Issue2May 1968Pages 223-229 RelatedInformation