[Predictive value of plasma interleukin-6 level in the diagnosis of early neonatal sepsis]

Neonatal sepsis is one of the common causes of neonatal mortality and morbidity. This study was aimed to evaluate the plasma interleukin-6 [IL-6] level as an early marker of neonatal sepsis. This study was conducted on 142 term neonates admitted to the neonatal intensive care unit of Kashan Shahid Beheshti hospital during 2010-11. The plasma IL-6 level of cases was determined using the electrochemiluminescence method. Ten icteric neonates with no signs or symptoms of sepsis were treated with phototherapy. Bactec blood culture was performed in 132 cases of suspected sepsis. Ten cases had positive blood culture and 122 negative blood culture with symptoms of sepsis. Then the levels of IL-6, in10 positive blood culture, 10 negative blood culture and another 10 cases with no symptoms of sepsis, were compared using Kruskal-Wallis test. Seventy-four cases were male and 68 were female. The incidence of neonatal sepsis was 7%. The most common bacterial agents were group B Streptococcus and Staphylococcus epidermidis. Tachypnea [35.9%] was the most common sign among the admitted neonates. The mean IL-6 level in the first [suspected sepsis with a positive blood culture], the second [suspected sepsis with a negative blood culture] and the control group [icteric neonates] were 1545.65, 14.79 and 11.04 micro g/dl, respectively [P=0.001]. The plasma IL-6 level can be a good predictor of early neonatal sepsis

[ correlation between neonatal phototherapy and risk of childhood asthma in children referred to pediatric clinic of Kashan Shahid Beheshti hospital during 2009-10]

Asthma is the most common chronic disease in childhood. Several factors have been considered as the disease risk factors. The neonatal phototherapy has recently been recognized as the main childhood risk factor. The aim of this study was to evaluate the relationship between the neonatal phototherapy and childhood asthma. This analytical case-control study was conducted on the asthmatic children with a history of neonatal icterus as the case group and those with no history of neonatal icterus as the control group with similar characteristics [age, gender, type of delivery and birth weight]. Twenty-eight out of 200 subjects in the case and 34 in the control group had the inclusion criteria. Phototherapy and its duration were compared in the case and control groups. Data were analyzed using chi-square and t-test. Twenty-six [92.8%] subjects in the case group and 20 [58.8%] subjects in the control group had a past history of phototherapy [P=0.002]. The mean number of days for neonatal phototherapy in the case and control groups was 4.9 and 3.2, respectively [P=0.001]. This study shows that neonatal phototherapy, as well as its duration, is an effective factor affecting childhood asthma. So, the phototherapy must be avoided except in rare situations with the least duration

[Causes of admission in low birth weight infants in Kashan Beheshti hospital 2005]

Low birth weight is associated with high mortality, morbidity and rates of admission among neonates. The aim of this study was to determine the causes of admission and outcome of low birth weight infants [LBW] admitted in Beheshti Hospital. In this cross sectional descriptive study, all the LBW infants admitted in Beheshti Hospital during a one year period [2005] were investigated. All data were collected from the medical records and analyzed by descriptive statistics. Of the 408 admitted neonates, one hundred and thirty six newborns were low of birth weight. Of whom 54.1% were male, 8 1.9% preterm and 18.1% intrauterine growth restricted [IUGR]. The mean gestational age in LBW infants, was 33.6 +/- 3.2 weeks and mean birth weight was 1845 +/- 392 and 2042 +/- 320 gr in preterm and IUGR infants respectively. The most common morbidities in LBW infants were sepsis, jaundice, hyaline membrane disease, anemia, hypocalcemia and hypoglycemia. The mean hospital stay was 14 +/- 9 days. The mortality rate in LBWs was 23.3% mainly in gestational age of less than 28 weeks and birth weight of <1000 gr. Considering the causes of admission in LBW infants and also prematurity as the main cause of low birth weight and mortality, we recommend prevention of preterm deliveries and improving the intensive care facilities

Pattern of congenital malformations in consanguineous versus nonconsanguineous marriages in Kashan, Islamic Republic of Iran

This study determined the types, patterns and prevalence of congenital malformation among the offspring of consanguineous and nonconsanguineous parents. In this prospective study of 3529 neonates delivered alive during a 1-year period, 109 had congenital malformations [3.09/1000 live births]. The rate of congenital malformation was 2.0% among neonates from nonconsanguineous marriages and 7.0% from consanguineous marriages. The most common malformations were genitourinary [32.1%], musculoskeletal [22.0%] and cardiovascular [14.7%]. Of the total malformed infants, 8.3% died within the neonatal period. Male infants were at greater risk for birth malformations. A history of congenital malformation was more common in siblings of consanguineous than nonconsanguineous marriages

Bacterial culture of neonatal sepsis

Neonatal bacterial sepsis is one of the major cause of morbidity and mortality in neonates. This retrospective study was performed to determine the incidence of bacterial sepsis with focus on Gram negative organisms in neonates admitted at Beheshti Hospital in Kashan, during a 3-yr period, from September 2002 to September 2005. Blood culture was performed on all neonates with risk factors or signs of suggestive sepsis. Blood samples were cultured using brain heart infusion [BHI] broth according to standard method. From the 1680 neonates 36% had positive blood culture for Pseudomans aerugi-nosa, 20.7% for Coagulase negative Staphylococci, and 17% for Klebsiella spp. Gram-negative organisms accounted for 72.1% of all positive cultures. The overall mortality rate was 19.8% [22/111] of whom 63.6% [14/22] were preterm. Pseudomona aeruginosa and Klebsiella spp. showed a high degree of resistance to commonly used antibiotics [ampicillin, gentamicin] as well as third generation cephalosporins. Continued local surveillance studies are urged to monitor emerging antimicrobial resistance and to guide interventions to minimize its occurrence

Increasing trend of antimicrobial drug-resistance in Pseudomonas aeruguiosa causing septicemia

The emergence of multi-drug resistant strains of Pseudomonas aeruginosa has complicated treatment decision and may lead to treatment failures. In this study, we describe the trends of drug-resistant P. aeruginosa isolated in blood cultures from patients detected in a tertiary teaching hospital and evaluated the prevalence of resistance to amikacin, ampicillin, carbeni- cillin, cefixime, cefotaxime, ceftazidime, ceftizoxime, ceftriaxone, gentamicin, imipenem, and trimethoprim/ sulfameth- oxazole in sixty-nine strains of P. aeruginosa isolated from neonates with septicemia in Kashan, Iran, from April, 2000 to June 2004. In assessment of the current breadth of multi-drug resistance in P. aeruginosa isolated from neonates with septicemia, 4.3% were susceptible to all studied agents, 10.1% were resistant to a single agent. Multi-drug resistance [MDR] isolates accounted for 73.9% of isolates. The majority of MDR isolates [41.2%] were resistant to three antimicrobial agents, which accounted for 30.4% of all isolates. Nineteen MDR isolates from fifty-one [37.3%] were resistant to four agents [19 out of 69; 27.5% of all isolates] and 21.6% to five agents [15.9% of all isolates]. Statistical analysis confirmed that there were no significant differences between multi-drug resistance phenotypes of isolates with age, gender, gestational age, outcome of septicemia, and application of respirator in neonates. Continued local surveillance studies are urged to monitor emerging antimicrobial resistance and to guide interventions to minimize its occurrence