ABSTRACT
Background:Late-onset sepsis [LOS] is well-defined as onset of sepsis more than 72 hours of age. Late onset thrombocytopenia occurs frequently due to sepsis
Objective: The aim of our study was to learn the incidence of thrombocytopenia in neonates with late onset nosocomial sepsis and to study the effects of different infectious organisms on platelet counts and thrombopiotin [Tpo] Level in Neonates with LOS
Methodology:This study was performed prospectively on 60 neonates from Neonatal Intensive Care Unit [NICU]. The sample eligibility criterion was the presence of documented nosocomial late onset sepsis [LOS]. Sixty non septicemic neonates from the same NICU were included in the study as a control group. All neonates were subjected to the following: Complete blood cell count, C-reactive protein assessment, blood culture and assesment of thrombopoietin level
Results: Our study showed that platelet counts were significantly lower among case group compared with control group [p<0.01]. This study showed that more than half of the cases had severe thrombocytopenia [53.13%] and the majority of them had bacteria culture test positive [83.3%] with high mortality among them [53.13%]. The most common isolated organism was klebsiellapneumoniae followed by Staph. aureus then Coagulase Negative Staphylococcus [CONS]. In our study, there was statistically significant association between platelet count in thrombocytopenic neonates and blood culture resultes among studied cases. There was significant inverse correlation between platelet count and Tpo level in thrombocytopenic group
Conclusion: Thrombocytopenia is an early marker of sepsis and can be used as a screening procedure for early detection of sepsis, especially in NICU. Type of organism in blood culture results affect both platlet count and Tpo level
ABSTRACT
Background: respiratory syncytial virus bronchiolitis is an important severe respiratory disease in infants, associated with substantial rates of morbidity and mortality. The exacerbated production of proinflammatory cytokines and chemokines in the airways with subsequent tissue and cell injury in response to RSV is an important pillar in the development and outcome of the disease. Nasal wash lactate dehydrogenase which is released from injured epithelial cells may add to the prediction of disease severity
Objectives: the objective of this study was to evaluate serum levels of two of inflammatory mediators; interleukin-6 [lL-6], tumour necrosis factor-alpha [TNF-alpha] and both serum and nasal wash lactate dehydrogenase [S. LDH and NWLDH] in infants with acute respiratory syncytial virus [RSV] bronchiolitis. We also tried to detect the correlation between their levels and the illness severity
Methods: infants older than 6 months old who presented with clinical symptoms of viral bronchiolitis were prospectively enrolled in the study. Nasal-wash [NW] samples were analyzed to detect RSV by polymerase chain reaction and quantify LDH concentration. Serum samples were submitted to quantify IL-6, TNF-alpha and LDH concentrations. Severity of disease was determined on the basis of the modified clinical scoring system, the duration of supplemental-oxygen and mechanical ventilation and the length of hospital stay also assisted
Results: a total of 55 infants were enrolled in the study, 41 [74.5%] were infected with RSV as detected by PCR. 18 of whom were severly ill and 23 were moderatly ill according to the modified clinical scoring system. The median concentrations in serum LDH and NWLDH were significantly higher in infants with severe than were those with moderate respiratory disease [p=0.002 and<0.0001 respectively] while no significant difference was observed according to IL6 and TNF-alpha highly significant negative correation between age and weight with severity was observed. SLDH and NWLDH levels presented a significant positive correlation with disease severity and the length of hospital stay, also between NWLDH and duration of oxygen therapy. There was a significant positive correlation between IL-6 and severity of disease, duration of oxygen therapy and the length of Hospital stay. While TNF-alpha presented a significant positive correlation with disease severity only. In respect to NWLDH high signifance was detected in comparison to other parameters in the study. However, no significant correlation was found between all the inflammatory mediators and the duration of mechanical ventilation. There were a highly significant positive correlation between NWLDH and SLDH (r= 07 p< 0.0001]
Conclusion: the measurement of LHD in nasal wash rather than serum IL-6,TNF-alpha and LDH is more beneficial for monitoring the severity of RSV bronchiolitis in infants population