ABSTRACT
Kluyvera ascorbata belongs to Enterobacteriaceae family and is a gram negative micro‑organism. This bacteria is usually considered a commensal, however it can cause significant infections rarely. This organism is usually resistant to most commonly used antibiotics used as first line in neonatal units. Antimicrobial agents active against Kluyvera strains include third‑generation cephalosporins, fluoroquinolones, and aminoglycosides. We report a case of an extremely low birth weight male infant who presented on day 4 of life with clinical features of sepsis, multi‑organ dysfunction, shock and pulmonary haemorrhage. Neonatal sepsis was associated with marked elevation of C‑reactive protein and a falling platelet count. Infant expired on day 5 of life in spite of aggressive supportive care and treatment with meropenem. with growth of Kluyvera ascorbataon blood culture.
ABSTRACT
Background: Fetal growth restriction and abnormal Doppler flow studies are commonly associated. Neonatal outcomes are not well known particularly in developing countries, where the burden of the disease is the highest. Objective: To determine outcomes of preterm infants with history of absent/reversed end-diastolic umbilical artery Doppler flow (AREDF) vs. infants with forward end-diastolic flow (FEDF). Design: Cohort study. Setting: Tertiary care perinatal center in India. Participants: 103 AREDF very low birth weight (<1500 gm) (VLBW) infants and 117 FEDF VLBW infants were prospectively enrolled. Results: At 40 weeks adjusted post-menstrual age, AREDF vs. FEDF group had a higher risk for death in the NICU (12% vs. 1%), respiratory distress syndrome (33% vs. 19%), and cystic periventricular leukomalacia (12% vs. 1%). At 12-18 months corrected age, AREDF vs. FEDF group had a trend towards increased risk for cerebral palsy (7% vs. 1%, P=0.06). After logistic regression analysis, adjusting for confounders, AREDF was independently associated only with mortality in the NICU. Conclusion: AREDF is an independent predictor of adverse outcomes in preterm infants in a developing country setting.