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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neonatal sepsis was studied among one hundred neonates (50 hospital born and 50 outborn babies) over one year period. The incidence of neonatal septicaemia was 15.5 per 1000 live births in the hospital. Among outborn babies it accounted for 6.1% of total pediatric admissions and 43.7% of sick neonates referred from outside. Low birth weight and prematurity were important predisposing factors in both the groups. Blood culture was positive among 32% of outborn and 34% of inborn babies. Coagulase-negative Staphylococcus, Klebsiella and Acinetobacter were the common causative organisms. All isolated organisms were sensitive to Gentamicin whereas 75% of them were resistant to Ampicillin. Mortality among outborn neonates (32%) was much higher in comparison to (10%) hospital born babies. Early identification of high risk antenatal cases and neonates and appropriate referral can bring down mortality and morbidity from neonatal sepsis.
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PMID:Neonatal septicaemia among inborn and outborn babies in a referral hospital. 180 Mar 36

Out of 6957 deliveries of the years 1987 and 1988 (7.2%) pregnant women have been analysed because premature rupture of fetal membranes. In 23.4 per cent symptoms of amniotic infection could be observed. In 31 per cent pathogenic germs could be identified from cervical swabs. In 33.6 per cent gestational period could be prolonged from 2 to 7 days, in 4.2 per cent more than 7 days. We found upon 32nd week of pregnancy a significant reduction of respiratory adaptation disturbances of 22%. Neonatal sepsis had been found at 50% till completion of 32nd week of pregnancy. Reasons for neonatal mortality are sepsis, immaturity and dysontogenesis. Conclusions have been made for practice in diagnostics and treatment.
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PMID:[Obstetric management and results of premature amniotic rupture]. 192 6

A modified biophysical profile was assessed serially in 47 patients with premature rupture of membranes who were not in labor. This profile included fetal movement, fetal tone, fetal breathing, amniotic fluid volume, and placental grade. The most recent study, obtained within 2 days of delivery, was compared with pregnancy outcome as reflected by the development of chorioamnionitis and/or neonatal sepsis. No study patient received antibiotics, steroids, or tocolytics before labor. Neither the composite biophysical profile nor any of its components were found to be different between patients with and without clinical chorioamnionitis. Neonatal sepsis was not observed. These data do not support the use of the biophysical profile as a predictor of maternal infection.
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PMID:Clinical chorioamnionitis is not predicted by an ultrasonic biophysical profile in patients with premature rupture of membranes. 200 95

Neonatal septicemia was assessed by blood cultures in 115 newborns (NB) during a two years study in a pediatric hospital of reference in Mexico City. The studied patients were divided in two groups of gestational age, and the differences of etiologic agents, clinical signs, laboratory findings and clinical outcome were compared at term and preterm neonates. We observed Staphylococcus epidermidis became the first cause of septicemia in at term NB (P less than 0.001), while Escherichia coli and Klebsiella pneumoniae (P less than 0.01) were more frequent in the preterm neonates. The clinical manifestations of fever (P less than 0.001), hepatomegaly (P less than 0.01), splenomegaly (P less than 0.05), and rejection to feeding (P less than 0.05) were more common in at term NB. On the other hand, apneas (P less than 0.01), hypothermia (P less than 0.02), and abdominal distension (P less than 0.05) were more frequent in the preterm NB. The altered white blood cell counts were more commonly observed in the preterm group, as leukopenia (P less than 0.05), neutropenia (P less than 0.01), and high I/T ratio (P less than 0.05). There were not significant differences in complications or sequels between the two groups; however, the mortality ratio was higher in the preterm NB group (P less than 0.02). Changing etiology of neonatal septicemia is discussed, and we propose these kind of data are very useful for purpose of detection, diagnostic and treatment of septic neonates.
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PMID:[Neonatal septicemia: differences in full-term and pre-term newborn infants]. 234 9

Records were reviewed of all patients with premature rupture of the membranes (PROM) at or less than 34 weeks estimated gestational age (EGA) who delivered at University Hospital of Jacksonville, Florida, during 1987. That year 132 patients were identified, 3.1% of all deliveries. The mean time from membrane rupture to delivery was three days, and the duration of PROM seven or more days in 9% of cases. Chorioamnionitis was diagnosed in 20% of the mothers. Delivery was by cesarean section in 30% of cases, twice the primary rate at University Hospital for 1987. Sixty-five percent of infants were male, and 13 males and four females of the 132 infants died before or after birth, the majority due to prematurity. Respiratory distress syndrome (RDS) was found in 35 infants and in 80% of these cases the membrane ruptured at 30 weeks or less. Intraventricular hemorrhage (IVH) was diagnosed in 8% of cases. Neonatal sepsis was a common diagnosis (41% of deliveries) with incidence being similar at all gestational ages. The length of membrane rupture was not statistically significant when compared with neonatal sepsis (P = 0.39).
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PMID:Premature rupture of membranes prior to 34 weeks gestational age. One year experience at a tertiary center. 261 60

From August 1980 through July 1984, 19 neonates had sepsis due to Haemophilus influenzae. Onset of disease occurred within 48 hours after birth of all the neonates. One neonate was born at term and 18 were born prematurely, including seven neonates born before 28 weeks' gestation. Eight neonates and one fetus died, six of them within 24 hours of birth. Acute chorioamnionitis was present in the placentas. Those neonates with the most severe placental inflammation survived while all of those who died had moderate or only mild chorioamnionitis. Acute villitis was noted in the placentas of three neonates who died. Respiratory distress syndrome (in 15 neonates) and pneumonia (in 15 neonates) were noted in 18 liveborn patients. Nine mothers had fever, six of them with genitourinary infections and one with septicemia due to H influenzae. All isolates of H influenzae were submitted for serologic typing and none were typable. In 14 cases, isolates were biotyped yielding eight with biotype II, four with biotype III, and one each with biotypes IV and V. Neonatal sepsis due to nontypable H influenzae is now nearly as common as sepsis due to group B Streptococcus. Both organisms produce diseases with many features in common, especially fulminant courses with respiratory distress and pneumonia, and often have a fatal outcome.
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PMID:Neonatal sepsis due to nontypable Haemophilus influenzae. 348 94

Neonatal sepsis due to group B beta-hemolytic Streptococcus (GBS) is reported to occur in about 1 out of 330 live births. Right-sided Bochdalek hernia (RBH) occurs in about 1 of 20,000 live births. The combination of group B streptococcal sepsis and delayed appearance of a right Bochdalek hernia is an infrequently reported phenomenon--18 patients have been previously reported in the English literature. We add four patients from our own experience to these previous reports. Since approximately 10% to 15% of the newborn population are exposed to group B Streptococcus we suspect that the inadequate diaphragmatic motion on the side of the Bochdalek hernia predisposes the child to development of septicemia and/or pneumonitis. Once the etiology has been established and appropriate antibiotic therapy instituted, progressive improvement in the patient's course should be seen. This is in contrast to a very significant mortality rate in many of the patients having early onset GBS. Any child, therefore, surviving early onset GBS only to deteriorate again, should be suspected of having an associated right Bochdalek hernia, and diagnostic steps should be taken to evaluate the integrity of the right diaphragm.
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PMID:Diagnosis and treatment of right Bochdalek hernia associated with group B streptococcal pneumonia and sepsis in the neonate. 635 94

Antibiotics are frequently prescribed "prophylactically" when the neonate is considered to be at risk for infection. The risk factors of prolonged rupture of membranes (greater than 24 hours), maternal fever/infection, and/or unexplained preterm labor (suggesting possible anmiotic fluid infection) were investigated in 276 babies. Only two of 150 babies investigated for a single factor proved to have sepsis, while of the 126 babies who had multiple factors, 13 had sepsis. Several laboratory tests, used singly or in combination, were more helpful than clinical manifestations in predicting which babies were likely to be infected. Neonatal sepsis was present in 6 per cent of the total, in 10 per cent of neonates with clinical signs, in 21 per cent with an increased immature/total neutrophil ratio (I/T ratio greater than or equal to 0.2), and in 36 per cent of infants with a positive "sepsis screen." The incidence of "infection" (sepsis and "very probable" infection) was 12 per cent overall, but was 14 per cent with neonatal signs, 44 per cent with I/T ratio greater than or equal to 0.2, and 74 per cent in those with a positive sepsis screen. A leukocyte count less than 5,000/cu mm and/or an I/T ratio greater than or equal to 0.2 was 100 per cent sensitive for sepsis, but the sepsis screen was most "efficient" at detecting "infection." Starting antibiotics on the basis of risk factors alone does not seem appropriate. In situations where amniotic fluid infection is possible, evaluation with the leukocyte count and differential (with or without other tests) could decrease the indiscriminate use of antibiotics, particularly when a single risk factor is the reason for suspecting infection.
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PMID:Neonatal sepsis resulting from possible amniotic fluid infection: risk and detection. 706 14

Neonatal sepsis is a clinical syndrome characterized by systemic signs and symptoms, and bacteremia during the first month of life. The incidence is relatively low (one to eight cases/1000 live births), yet the risk of mortality is approximately 25%. Meningitis in the neonate is usually a sequela of bacteremia; however, it is discussed with neonatal sepsis, because they commonly share etiology and pathogenesis. The incidence of meningitis is usually a fraction of the number of infants with sepsis, varying in different settings from one-fourth to one-third. The mortality rate is high, varying in some series from 15%-50%. There are two major forms of presentation of neonatal sepsis. Early-onset disease presents as a fulminant, multisystemic illness during the first 5-7 days of life; late-onset disease is more commonly recognized after the first weeks of life. Because different microorganisms are responsible for the two forms of disease, the choice of antimicrobial agents also differs. Some organisms such as Escherichia coli, group B streptococci, and Listeria monocytogenes may be responsible, whereas other pathogens such as Staphylococcus aureus and S. epidermidis, and Pseudomonas aeruginosa are usually associated with late-onset disease. Classic initial (empiric) treatment of neonatal sepsis and meningitis consists of ampicillin and an aminoglycoside. With the advent of the third-generation cephalosporins, however, the empiric antimicrobial approach for neonatal sepsis and meningitis has changed in most centers. Third-generation cephalosporins cover more of the pathogens implicated in neonatal sepsis and meningitis, except for the enterococci and L. monocytogenes.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cefotaxime for treatment of neonatal sepsis and meningitis. 758 23

The objective of this study was to prospectively evaluate the incidence of neonatal sepsis after prolonged premature rupture of membranes (PROM), to correlate sepsis with gestational age and with the duration of PROM, and to evaluate the necessity for prophylactic antibiotic therapy in neonates born after PROM. Of 12,182 infants, 135 (1.1%) were delivered after PROM with a latency period of > 24 hours. Neonatal sepsis occurred in 11 infants (8.1%), 10 of whom were premature. The only term, septic newborn was a small-for-gestational-age infant. A latency period > 72 hours was not associated with an increased incidence of sepsis. Maternal fever, neonatal signs of infection including leukopenia, leukocytosis, thrombocytopenia, and positive gastric aspirate cultures, were not good predictors of sepsis. Of premature infants with PROM, 15% had sepsis, and thus the administration of prophylactic antibiotic therapy in these cases may be warranted. However, it may be unnecessary to administer prophylactic antibiotics to term, appropriate-for-gestational-age infants born after PROM.
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PMID:Neonatal sepsis after prolonged premature rupture of membranes. 765 May 51


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