ABSTRACT
The hypothesis that catheter-related sepsis (CRS) may be preceded by contamination of the catheter hub was tested in neonates with central venous catheters. Cultures of the catheter hub were obtained three times per week. One hundred thirteen catheters were placed in 88 patients. Of 35 episodes of sepsis, 28 were catheter-related, for a catheter sepsis rate of 1.03/100 catheter-days. CRS occurred in 26 (23%) of 113 catheters. In 10 of 28 episodes, the infecting microorganism was cultured from the hub before its culture from blood obtained at the time of clinical sepsis. In an additional 5 cases, a culture of the catheter hub at the time of clinical sepsis yielded the same isolate as the blood culture. Thus, 54% of episodes of CRS were preceded by or coincided with contamination of the hub. The catheter hub may be a major portal of entry for microorganisms causing sepsis in a neonatal intensive care unit.
Subject(s)
Bacteremia/etiology , Catheterization, Central Venous , Catheters, Indwelling , Cross Infection/etiology , Fungemia/etiology , Humans , Infant, Newborn , Infant, Premature, Diseases/etiology , Intensive Care Units, Neonatal , Prospective StudiesABSTRACT
Plasma fibronectin concentration was measured in neonates of 2 to 5 days of age. Although breast fed and formula fed infants were similar in demographic characteristics, the mean (SD) plasma concentration of fibronectin in 26 breast fed infants, 237 (117) mg/l, was significantly higher than in 27 formula fed infants (171 (91) mg/l). Fibronectin was detected in five colostrum specimens (mean concentration 13.4 mg/l). Similar bands were detected after gel electrophoresis of purified adult plasma fibronectin and whole plasma from breast fed and formula fed neonates after staining or immunoblotting. Fibronectin isolated from breast milk also appeared similar to purified plasma fibronectin. It is possible, although unlikely, that fibronectin is absorbed intact from ingested colostrum. Alternatively, a factor(s) might be present in colostrum that contributes to the regulation of plasma fibronectin concentration.
Subject(s)
Bottle Feeding , Breast Feeding , Fibronectins/blood , Colostrum/analysis , Female , Humans , Infant Food/analysis , Infant, Newborn , Male , Milk, Human/analysis , PregnancyABSTRACT
Eosinophilic cellulitis (Wells' syndrome) is characterized by recurrent episodes of nonpruritic, indurative, cutaneous swellings. Three cases of this syndrome occurred in two male siblings and their mother. In all three family members, skin lesions appeared early in infancy. Unusual clinical manifestations included eosinophilic pleural effusions and pericarditis.
Subject(s)
Cellulitis/genetics , Eosinophilia/genetics , Adult , Cellulitis/pathology , Child, Preschool , Eosinophilia/pathology , Female , Humans , Infant , Infant, Newborn , MaleSubject(s)
Infant, Low Birth Weight , Jaundice, Neonatal/mortality , Phototherapy , Actuarial Analysis , Autopsy , Exchange Transfusion, Whole Blood , Female , Gestational Age , Humans , Infant, Newborn , Jaundice, Neonatal/complications , Jaundice, Neonatal/prevention & control , Kernicterus/etiology , Male , Racial Groups , Respiratory Distress Syndrome, Newborn/mortality , Sudden Infant Death/etiologyABSTRACT
The infant with elevated direct-reacting bilirubin levels requires an early specific diagnosis to identify those who would require early surgical intervention and those in whom the bilirubin levels will eventually return to normal. This study compares the accuracy of three tests: the serum lipoprotein-X (LP-X), the I131 rose bengal (IRB) excretion and the serum alpha-fetoprotein (AFP) in making a specific diagnosis in 15 patients. When used individually the accuracy of the tests varies from 56-100%. The LP-X and IRB excretion are more specific and when in agreement are 100% acurate in the diagnosis of the neonatal hepatitis syndrome (NHS) or extrahepatic biliary obstruction (EHBO). This study suggests that both the LP-X and IRB excretion should be used in the investigation of the infant with conjugated hyperbilirubinemia.
Subject(s)
Biliary Tract Diseases/diagnosis , Cholestasis/diagnosis , Hepatitis/diagnosis , Infant, Newborn, Diseases/diagnosis , Lipoproteins/blood , Biliary Tract Diseases/blood , Biliary Tract Diseases/complications , Cholestasis/blood , Cholestasis/etiology , Hepatitis/blood , Hepatitis/complications , Humans , Infant , Infant, Newborn , Infant, Newborn, Diseases/blood , Rose Bengal , alpha-Fetoproteins/analysisABSTRACT
Ichthyosiform erythroderma is a rare phenomenon occurring in about 1/300,000 live births. Congenital unilateral ichthyosis, described in this case report, is a clinical variant of ichthyosis. Only five previous cases have been reported. In the patient described in this report, superimposed infection of the affected skin developed. Her immunologic system was intact. She manifested failure to thrive, in spite of an adequate caloric intake, and markedly delayed psychomotor development. This patient also demonstrated absorption from the affected dermis of topically applied urea hydrophilic base ointment. She died before her first birthday.
Subject(s)
Ichthyosis/congenital , Female , Humans , Ichthyosis/pathology , Infant , Infant, NewbornABSTRACT
Two newborns with stigmata of Down syndrome required resuscitation at birth because of unilateral congenital chylous pleural effusion. After thoracentesis, ventilation was improved. Congenital chylous pleural effusion in newborns with Down syndrome has not previously been described. Pleural effusion at birth must be promptly diagnosed and aspirated.
