A case of undiagnosed Bordetella pertussis infection in a neonate.

Case report: We encountered a 28 -day -old infant with progressive respiratory failure diagnosed with pertussis after discharge from the hospital. Here, we describe the disease course, diagnostic difficulties and treatment procedure. After 20 days of treatment based on the doctors' experience (without an established diagnosis), the child was deemed healthy and discharged. At the 6 -month follow -up, the child was healthy and showed normal development. No other Bordetella pertussis infections among newborns or hospital staff who were in contact with the patient and his family were reported. Conclusion: Pertussis morbidity is high in infants younger than 6 months, and the disease should be suspected in any case of respiratory failure. The serological diagnosis of pertussis depends mostly on the organization and effectiveness of the healthcare system; therefore, medical history and physical examination are vital factors in the diagnostic process. The treatment of pertussis in infants should take place in centres with an intensive care unit.

[Nosocomial infections in a neonatology department, 1995-2002]. / Zakazenia szpitalne w oddziale neonatologii w latach 1995-2002.

Nosocomial infections in newborns department are common due to number of invasive diagnostic and therapeutic procedures, prolonged hospitalization and development antibiotic resistance culture. Sepsis achieved 1 to 8 newborn infants for 1000 live births. This is still unresolved very important medical, organization, ethical and medical problem. The aim of this study was the estimation on the number, etiology and clinical form of nosocomial infection in Neonatology Department as well as the way of spread. We analyzed nosocomial infection in 8770 newborn infants in Neonatology Department with Intensive Therapy Chair and Clinic Obstetric and Perinatology Pomeranian University of Medicine from 1995 to 2002. For this retrospective study we used data from Commission for Nosocomial Infection. In analyzed period total percentage of newborn infants with nosocomial infection was under 1%, but in NICU was over 11%. Inborn vertical infection was 26.8% and horizontal strictly nosocomial infection was diagnosed in 73.2%. Etiology was mainly due to Gram negative bacterial infection. Clinically sepsis, pneumonia and meningitis was diagnosed. Clinical manifestation and laboratory tests like CRP, PCT, blood count, leukocyte index and microbiological culture was used for diagnosis. The most often positive bacterial culture was obtained from cock, washstand, bath and medical staff. Nosocomial infections in neonatology department are significant medical problem which need continuous monitoring, systemic prevention and in case of infection early intervention.