Background: To examine the differences in prevalence of respiratory distress syndrome, early-onset sepsis and jaundice, between late preterm infants versus term infants in Ecuadorian newborns. Methods: Study design: E...Background: To examine the differences in prevalence of respiratory distress syndrome, early-onset sepsis and jaundice, between late preterm infants versus term infants in Ecuadorian newborns. Methods: Study design: Epidemiological, observational, and cross-sectional, with two cohorts of patients. Settings: IESS Quito Sur Hospital at Quito, Ecuador, from February to April of 2020. Participants: This study included 204 newborns, 102 preterm infants, 102 term infants. Results: There are significant differences between late preterm infants and term infants, with a p-value of 0.000 in the prevalence of early sepsis, 70.59% vs. 35.29%. In respiratory distress syndrome between late and term premature infants, significant differences were observed with a p-value of 0.000, the proportion being 55.58% vs. 24.51% respectively. The prevalence of jaundice is higher in term infants with a p value of 0.002, 72.55%, versus 51.96% in late preterm infants, and the mean value of bilirubins in mg/dL was higher in term infants 14.32 versus 12.33 in late preterm infants;this difference is statistically significant with a p value of 0.004. Admission to the NICU is more frequent in late preterm infants with a p-value of 0.000, being 42.16% for late preterm infants vs. 7.84% in term infants;the mean of the hospital days with p-value 0.005, was higher in late preterm infants 4.97 days vs. 3.55 days for term newborns. Conclusion: Due to the conditions of their immaturity, late preterm infants are 2.86 times more likely to present early sepsis than full-term newborns. It is shown that late preterm infants are 2.69 times more likely to have respiratory distress syndrome compared to term infants, therefore, late preterm infants have a longer hospital stay of 4.97 days versus 3.55 days in term infants. Jaundice and mean bilirubin levels are higher in term infants due to blood group incompatibility and insufficient breastfeeding.展开更多
Esculetin,a natural derivative from the traditional and widely-used Chinese medicinal herb Cortex Fraxini,has a variety of pharmacological effects,especially in anti-inflammation.However,it is not clear whether escule...Esculetin,a natural derivative from the traditional and widely-used Chinese medicinal herb Cortex Fraxini,has a variety of pharmacological effects,especially in anti-inflammation.However,it is not clear whether esculetin has a therapeutic effect on sepsis.This study aimed to investigate the anti-inflammatory and protective effects of esculetin on early sepsis.The results showed that the lung injury was significantly relieved with the treatment of esculetin,accompanied with the restrained production of inflammatory factors including IL-1β,IL-6,TNF-α,CCL2 and iNOS during the early phase of E.coli-induced sepsis.Of note,activation of NF-κB and STAT1/STAT3 signals,the main upstream signals of many inflammatory factors,were attenuated by esculetin in both lung tissues from septic mice and LPS-stimulated macrophage.These findings suggested that the protection of esculetin against early sepsis should be related to its anti-inflammatory effect,which was at least partly due to its inhibition on NF-κB and STAT1/STAT3 signaling pathway in macrophage.Thus,esculetin could serve as a potential therapeutic agent by rebalancing innate immune response in macrophage for the treatment of early sepsis.展开更多
Background Kaiser Sepsis Calculator(KSC)reduces antibiotic use,testing and intravenous infiltrates but there are concerns about the missed early onset sepsis(EOS)cases.We sought to apply the KSC score for culture-posi...Background Kaiser Sepsis Calculator(KSC)reduces antibiotic use,testing and intravenous infiltrates but there are concerns about the missed early onset sepsis(EOS)cases.We sought to apply the KSC score for culture-positive infants retrospectively in infants born in the last 10 years in our hospital.Methods In a retrospective cohort study,the comparison groups were divided into Group A(no antibiotics recommended by KSC)and Group B(antibiotics recommended).Results Overall,17/24(71%)infants would have been started on antibiotics per KSC but 7/24(29%)would not.The initial EOS risk was not significantly different between the groups(Group A vs.Group B:0.44 vs.0.76,P=0.41),but the final risk score was(0.33 vs.9.41,P<0.001).In Group A(no antibiotics),3/7 infants became symptomatic between 9 and 42 hours.Conclusion There may be a potential delay in starting antibiotics in infants that are asymptomatic at birth while using KSC.展开更多
Importance:Effective screening strategies for early-onset neonatal sepsis(EONS)have the potential to reduce high volume parenteral antibiotics(PAb)usage in neonates.Objective:To compare management decisions for EONS,b...Importance:Effective screening strategies for early-onset neonatal sepsis(EONS)have the potential to reduce high volume parenteral antibiotics(PAb)usage in neonates.Objective:To compare management decisions for EONS,between CG149 National Institute for Health and Care Excellence(NICE)guidelines and those projected through the virtual application of the Kaiser Permanente sepsis risk calculator(SRC)in a level 2 neonatal unit at a district general hospital(DGH).Methods:Hospital records were reviewed for maternal and neonatal risk factors for EONS,neonatal clinical examination findings,and microbial culture results for all neonates born at≥34 weeks’gestation between February and July 2019,who were(1)managed according to CG149-NICE guidelines or(2)received PAb within 72 h following birth at a DGH in Winchester,UK.SRC projections were obtained using its virtual risk estimator.Results:Sixty infants received PAb within the first 72 h of birth during the study period.Of these,19(31.7%)met SRC criteria for antibiotics;20(33.3%)met the criteria for enhanced observations and none had culture-proven sepsis.Based on SRC projections,neonates with’’≥1 NICE clinical indicator and≥1 risk factor’were most likely to have a sepsis risk score(SRS)>3.Birth below 37 weeks’gestation(risk ratio[RR]=2.31,95%confidence interval[CI]:1.02–5.22)and prolonged rupture of membranes(RR=3.14,95%CI:1.16–8.48)increased the risk of an SRS>3.Interpretation:Screening for EONS on the SRC could potentially reduce PAb usage by 68%in term and near-term neonates in level 2 neonatal units.展开更多
<strong>Background:</strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> Maternal colonization with group B st...<strong>Background:</strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> Maternal colonization with group B streptococcus (GBS) is an important risk factor for neonatal sepsis. A “mikveh” is a pool of water for ritual immersion by Jewish women. It had been reported to be a risk factor </span><span style="font-family:Verdana;">f</span><span style="font-family:Verdana;">or G</span><span><span style="font-family:Verdana;">BS colonization. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To determi</span></span><span style="font-family:Verdana;">ne whether there is an associ</span><span style="font-family:Verdana;">ation </span><span><span style="font-family:Verdana;">between ritual immersion in the mikveh pools and GBS carriership. </span><b><span style="font-family:Verdana;">Methods: </span></b></span><span style="font-family:Verdana;">Water samples and bacterial swabs were taken from eight mikveh pools centers at two separate occasions and tested for GBS growth. For determination of the total number of live, aerobic bacteria, each sample was grown on strep selective agar for 48 hours at 37<span style="white-space:nowrap;">°</span>C and CO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> 5%. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> All the samples were tested. No trace of GBS was found in any of the samples. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> The findings of this study refute earlier findings and suggest that there is no association between ritual immersion in mikvehs and GBS carriership.</span></span></span></span>展开更多
文摘Background: To examine the differences in prevalence of respiratory distress syndrome, early-onset sepsis and jaundice, between late preterm infants versus term infants in Ecuadorian newborns. Methods: Study design: Epidemiological, observational, and cross-sectional, with two cohorts of patients. Settings: IESS Quito Sur Hospital at Quito, Ecuador, from February to April of 2020. Participants: This study included 204 newborns, 102 preterm infants, 102 term infants. Results: There are significant differences between late preterm infants and term infants, with a p-value of 0.000 in the prevalence of early sepsis, 70.59% vs. 35.29%. In respiratory distress syndrome between late and term premature infants, significant differences were observed with a p-value of 0.000, the proportion being 55.58% vs. 24.51% respectively. The prevalence of jaundice is higher in term infants with a p value of 0.002, 72.55%, versus 51.96% in late preterm infants, and the mean value of bilirubins in mg/dL was higher in term infants 14.32 versus 12.33 in late preterm infants;this difference is statistically significant with a p value of 0.004. Admission to the NICU is more frequent in late preterm infants with a p-value of 0.000, being 42.16% for late preterm infants vs. 7.84% in term infants;the mean of the hospital days with p-value 0.005, was higher in late preterm infants 4.97 days vs. 3.55 days for term newborns. Conclusion: Due to the conditions of their immaturity, late preterm infants are 2.86 times more likely to present early sepsis than full-term newborns. It is shown that late preterm infants are 2.69 times more likely to have respiratory distress syndrome compared to term infants, therefore, late preterm infants have a longer hospital stay of 4.97 days versus 3.55 days in term infants. Jaundice and mean bilirubin levels are higher in term infants due to blood group incompatibility and insufficient breastfeeding.
基金supported by the Key Project of Scientific Research Fund of Hunan Provincial Education Department(15A177)the Natural Science Foundation of Hunan Province(2019JJ40275).
文摘Esculetin,a natural derivative from the traditional and widely-used Chinese medicinal herb Cortex Fraxini,has a variety of pharmacological effects,especially in anti-inflammation.However,it is not clear whether esculetin has a therapeutic effect on sepsis.This study aimed to investigate the anti-inflammatory and protective effects of esculetin on early sepsis.The results showed that the lung injury was significantly relieved with the treatment of esculetin,accompanied with the restrained production of inflammatory factors including IL-1β,IL-6,TNF-α,CCL2 and iNOS during the early phase of E.coli-induced sepsis.Of note,activation of NF-κB and STAT1/STAT3 signals,the main upstream signals of many inflammatory factors,were attenuated by esculetin in both lung tissues from septic mice and LPS-stimulated macrophage.These findings suggested that the protection of esculetin against early sepsis should be related to its anti-inflammatory effect,which was at least partly due to its inhibition on NF-κB and STAT1/STAT3 signaling pathway in macrophage.Thus,esculetin could serve as a potential therapeutic agent by rebalancing innate immune response in macrophage for the treatment of early sepsis.
文摘Background Kaiser Sepsis Calculator(KSC)reduces antibiotic use,testing and intravenous infiltrates but there are concerns about the missed early onset sepsis(EOS)cases.We sought to apply the KSC score for culture-positive infants retrospectively in infants born in the last 10 years in our hospital.Methods In a retrospective cohort study,the comparison groups were divided into Group A(no antibiotics recommended by KSC)and Group B(antibiotics recommended).Results Overall,17/24(71%)infants would have been started on antibiotics per KSC but 7/24(29%)would not.The initial EOS risk was not significantly different between the groups(Group A vs.Group B:0.44 vs.0.76,P=0.41),but the final risk score was(0.33 vs.9.41,P<0.001).In Group A(no antibiotics),3/7 infants became symptomatic between 9 and 42 hours.Conclusion There may be a potential delay in starting antibiotics in infants that are asymptomatic at birth while using KSC.
文摘Importance:Effective screening strategies for early-onset neonatal sepsis(EONS)have the potential to reduce high volume parenteral antibiotics(PAb)usage in neonates.Objective:To compare management decisions for EONS,between CG149 National Institute for Health and Care Excellence(NICE)guidelines and those projected through the virtual application of the Kaiser Permanente sepsis risk calculator(SRC)in a level 2 neonatal unit at a district general hospital(DGH).Methods:Hospital records were reviewed for maternal and neonatal risk factors for EONS,neonatal clinical examination findings,and microbial culture results for all neonates born at≥34 weeks’gestation between February and July 2019,who were(1)managed according to CG149-NICE guidelines or(2)received PAb within 72 h following birth at a DGH in Winchester,UK.SRC projections were obtained using its virtual risk estimator.Results:Sixty infants received PAb within the first 72 h of birth during the study period.Of these,19(31.7%)met SRC criteria for antibiotics;20(33.3%)met the criteria for enhanced observations and none had culture-proven sepsis.Based on SRC projections,neonates with’’≥1 NICE clinical indicator and≥1 risk factor’were most likely to have a sepsis risk score(SRS)>3.Birth below 37 weeks’gestation(risk ratio[RR]=2.31,95%confidence interval[CI]:1.02–5.22)and prolonged rupture of membranes(RR=3.14,95%CI:1.16–8.48)increased the risk of an SRS>3.Interpretation:Screening for EONS on the SRC could potentially reduce PAb usage by 68%in term and near-term neonates in level 2 neonatal units.
文摘<strong>Background:</strong><span><span><span style="font-family:;" "=""><span style="font-family:Verdana;"> Maternal colonization with group B streptococcus (GBS) is an important risk factor for neonatal sepsis. A “mikveh” is a pool of water for ritual immersion by Jewish women. It had been reported to be a risk factor </span><span style="font-family:Verdana;">f</span><span style="font-family:Verdana;">or G</span><span><span style="font-family:Verdana;">BS colonization. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To determi</span></span><span style="font-family:Verdana;">ne whether there is an associ</span><span style="font-family:Verdana;">ation </span><span><span style="font-family:Verdana;">between ritual immersion in the mikveh pools and GBS carriership. </span><b><span style="font-family:Verdana;">Methods: </span></b></span><span style="font-family:Verdana;">Water samples and bacterial swabs were taken from eight mikveh pools centers at two separate occasions and tested for GBS growth. For determination of the total number of live, aerobic bacteria, each sample was grown on strep selective agar for 48 hours at 37<span style="white-space:nowrap;">°</span>C and CO</span><sub><span style="font-family:Verdana;">2</span></sub><span style="font-family:Verdana;"> 5%. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> All the samples were tested. No trace of GBS was found in any of the samples. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> The findings of this study refute earlier findings and suggest that there is no association between ritual immersion in mikvehs and GBS carriership.</span></span></span></span>
