ABSTRACT
A total of 76 premature newborn infants with gestational age of 34 weeks or less were enrolled in a randomized controlled study to determine whether intravenously administrated immunoglobulin (IVIG) is able to prevent nosocomial sepsis. Forty infants were given 0.5 g/kg IVIG on the first day of life and 36 infants with similar gestational age and birth weight were selected as controls and did not receive IVIG. The frequency of proven sepsis, with a positive blood and/or cerebrospinal fluid culture, was significantly lower in infants who received IVIG as compared to controls (42.5 vs 80.0%) (p < 0.01). The mortality rate attributable to infection was not different in IVIG recipients and in controls (41 vs 48%) (p > 0.05). The overall mortality rates in the two groups were not different either (35.0 vs 44.4%) (p > 0.05). The majority of micro-organisms isolated from the blood culture of the patients were gram negative microorganisms (Klebsiella, Enterobacter). IVIG therapy was believed to be effective for prophylaxis of nosocomial infection, but such therapy was not able to reduce overall mortality rate or mortality rate due to systemic infection in prematurely born infants in our intensive care unit where the causative pathogens are usually gram negative microorganisms.
Subject(s)
Cross Infection/immunology , Female , Gestational Age , Hospital Mortality , Humans , Immunization, Passive , Infant, Newborn , Infant, Premature, Diseases/immunology , Male , Risk Factors , Treatment Outcome , TurkeySubject(s)
Complement C3/analysis , Complement C4/analysis , Complement System Proteins/analysis , Fetal Blood/immunology , Gestational Age , Humans , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Immunoglobulins/analysis , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases/immunologyABSTRACT
We studied 125 clinically suspected septicemic neonates (Patient) aged from 1 to 28 days and 25 healthy neonates (control) of comparable age and sexes. Cultures of blood were done and serum immunoglobulins (IgG, IgA) were estimated in all the subjects. Blood cultures were found positive in 45 (36%) patients. Preterm patients showed significantly higher number of positive blood cultures as compared to term patients. The mean serum IgG level in patients was found significantly lower than that of the controls. The serum IgG levels were also found significantly lower in 75 preterm as compared to 50 term, and in 45 blood culture positive patients as compared to 80 blood culture negative patients. On the other hand, the mean serum IgM level in patients was found significantly higher as compared to controls. Similarly, serum IgM levels were found higher in preterm patients as compared to term patients and in blood culture positive patients as compared to blood culture negative patients. No significant difference of mean serum IgA level was found among the subjects. It is evident from our study, that blood culture positive patients were mostly preterm, in whom transplacental passage of IgG is insufficient and due to low IgG level, preterm baby cannot counteract bacterial invasion and as such, suffer from septicemia more frequently. Septicemic neonates as a rule showed higher level of serum IgM due to synthesis by themselves in primary response to infection.
Subject(s)
Humans , Immunoglobulins/analysis , Infant, Newborn , Infant, Premature, Diseases/immunology , Sepsis/immunologyABSTRACT
Como as características clínicas da infecçäo humana por campylobacter em pacientes recém-nascidos näo estäo ainda bem documentadas, considerou-se interessante comunicar a ocorrência de dois casos simultâneos de enterite por C. coli em gêmeos monozigotos. Discute-se a história clínica, os aspectos epidemiológicos e microbiológicos, o desenvolvimento de imunidade bem cocmo a síntese de Ig totais, tendo em consideraçäo as estreitas relaçöes genético-ecológicas destes dois casos