Respiratory tract culture: could it be an additional diagnostic modality of neonatal sepsis?

Study objective is to evaluate the role of respiratory tract colonization pattern-in predicting pathogens isolated during episodes of neonatal sepsis. A prospective study including 50 septic newborns [21 full term and 29 preterm] was carried in the neonatal intensive care units [NICUs] of Cairo University [Kasr el Aini and Abou el Riche Children Hospital] during the period between March 2007 and December 2007. In addition to routine laboratory work up for sepsis, culture was performed on respiratory specimens obtained using either blind [non bronchoscopic] bronchoalveolar lavage [BAL] or tracheal aspirate [TA]. Comparing blood and respiratory cultures regarding the presence of bacterial growth, there was a statistically significant relation between them; as we retrieved the same organism in almost 30% of cases. In conclusion, Culture of tracheal secretions could be of use as an indicator of changes taking place in the NICU environment. However, it is recommended only if clinical signs point out pneumonia, associated with variation in amount and character of secretions, even if the chest x-ray shows no abnormality. Cultures of tracheal aspirates could not substitute the blood culture in diagnosis of neonatal sepsis

Study of the newborn feeding behaviors and fentanyl concentration in colostrum after an analgesic dose of epidural and intravenous fentanyl in cesarean section

To compare the effects of epidural and intravenous fentanyl on breast feeding behaviors and fentanyl concentration in the colostrum after an analgesic dose. This study was conducted at the Obstetrics Department of Kasr El-Aini Hospital-Cairo University, Cairo, Egypt. The studied mothers were 100 multipara, who have been subjected to cesarean section, and have a previous history of successful breast feeding. The study was conducted from May 2005 to May 2007. They were divided into 2 groups: group I included 50 patients who received epidural anesthesia with fentanyl, and group II included 50 patients who received spinal anesthesia with intravenous fentanyl, and both groups were observed for initial breast feeding behaviors of newborns, and fentanyl concentration in the colostrum at 45 minutes, and 24 hours after birth. The study included 100 multipara, 2 samples of colostrum were taken from each patients at 45 minutes, and at 24 hours. The levels of fentanyl concentration were greatest at 45 minutes of the initial sampling time, reaching 0.40 +/- 0.059 ng/ml in the epidural group, and 0.19 +/- 0.019 ng/ml in intravenous fentanyl group. There was no statistical difference in breast feeding behaviors at birth, or at 24 hours of age in both groups. Although the levels of fentanyl concentration were greatest at 45 minutes of the initial sampling time, it can be used safely as intravenous or epidural without affecting the initial breast feeding behaviors of the newborn