The Analysis of Etiology and Risk Factors for 192 Cases of Neonatal Sepsis.

This study aimed to investigate the etiology and risk factors of neonatal sepsis. A retrospective analysis was conducted on 192 patients with sepsis from August 2013 to March 2015. One hundred and six healthy neonates were used as the control group. Logistic regression was used to analyze the risk factors and ROC curve analysis performed in laboratory which indicated a significant correlation. The results of univariate analysis showed that postnatal age, body weight, and parity were significantly related to neonatal sepsis (P < 0.5). Logistic regression analysis demonstrated that postnatal age and parity are independent risk factors for neonatal sepsis (OR were 1.176 and 0.692, resp., P < 0.001). The maximum area underneath the curve (ROCAUC) of soluble CD14 (sCD14-ST), which was the most indicative biomarker of sepsis diagnostically, was 0.953 with sensitivity and specificity of 93.8% and 84.9%, respectively. Escherichia coli, Staphylococcus aureus, and Streptococcus agalactiae were the main bacterial strains causing neonatal sepsis, while postnatal age was an independent risk factor for the onset of disease. sCD14-ST could be a potential useful diagnostic marker for pediatric sepsis.

The clinical significance of sCD14-ST for blood biomarker in neonatal hematosepsis: A diagnostic accuracy study.

Hematosepsis is a systemic inflammatory response syndrome (SIRS) with suspected or confirmed infection, which is the most common infectious disease in clinical neonatal intensive care unit. As the rapid development of neonatal hematosepsis caused by various basic diseases, the mortality rate is high, and there are some sequelae.We report the lasted study to date with 96 cases from Fujian Longyan First Hospital between 2013 and 2015. The aim of our study is to explore the value of soluble cluster of differentiation 14 subtype (sCD14-ST) in whole blood for differential diagnosis of neonatal hematosepsis at an early stage, and used in evaluation of the severity about sepsis combined with acute physiology and chronic health evaluation II (APACHE-II) score, procalcitonin (PCT), C reactive protein (CRP), and leukocyte (WBC).In our cohort, all cases met the diagnostic criteria for hematosepsis specific for newborns. We selected 42 neonates with hematosepsis, 54 neonates with nonhematosepsis, 44 noninfectious SIRS neonates, and 53 healthy neonatal controls. Which were determined the sCD14-ST, PCT, CRP, and WBC of all samples before treatment. Then assign the APACHE-II score for the all samples before and after treatment.The study shows, sCD14-ST levels were significantly higher in hematosepsis than nonhematosepsis group (t = -2.112, P = .041). Meanwhile, sCD14-ST levels were significantly higher in neonatal hematosepsis than in noninfectious SIRS group and controls (χ = 57.812, 68.944, P < .01). However, sCD14-ST in hematosepsis group was positively correlated with APACHE-II score (R-value = 0.415, P < .01). During treatment, the sCD14-ST level was decreased obviously along with APACHE-II score, PCT, CRP, and WBC (χ = 35.019, 78.399, 52.363, 25.912, 7.252, all P values <.01). The area under the curve (AUC) of sCD14-ST was 0.942. The differences in ROC of sCD14-ST compared with PCT, CRP, and WBC were statistically significant (Z = -6.034, -4.474, -5.722, all P values <.01). The sensitivity and specificity of sCD14-ST were 95.2% and 84.9%, respectively.sCD14-ST could be a blood biomarker for early identification and disease valuation in newborns hematosepsis infection; and its diagnostic value is superior to other laboratory indexes.

Biofilm-Related Genes: Analyses in Multi-Antibiotic Resistant Acinetobacter Baumannii Isolates From Mainland China.

BACKGROUND Acinetobacter baumannii is an important nosocomial pathogen which shows a high level of mortality risk. Several papers have reported biofilm formation as a well-known pathogenic mechanism in A. baumannii infections and exceptional antibiotic resistance. The study aims to explore the potential relationships between biofilm-related genes and antimicrobial resistance. MATERIAL AND METHODS Samples from 122 patients with lower respiratory tract infections of A. baumannii were collected at Fujian Longyan First Hospital from January 2013 to September 2014. A. baumannii was isolated from sputum specimens. Biofilm-related genes including abaI, csuE, ompA, and bla-PER1 were analyzed by PCR. The minimum inhibitory concentration method was used to determine the sensitivity of each strain to antibiotics. RESULTS The clinical manifestations of A. baumannii-induced lower respiratory tract infections lacked specificity. Infected patients were most commonly admitted to intensive care units (54.9%) and frequently had chronic obstructive pulmonary disease (27.0%). The detection rates of abaI and csuE were both 59.8%, and those of ompA and bla-PER1 were 100% and 0%, respectively. After genetic testing, antimicrobial resistance to amikacin, ampicillin/sulbactam, and 14 other types of antimicrobials was higher in abaI- and csuE-positive strains than in abaI- and csuE-negative strains (P<0.05). CONCLUSIONS The findings of our study suggest that abaI- and csuE-positive Acinetobacter baumannii strains are associated with a higher incidence of antibiotic resistance in 14 types of antimicrobials.