scholarly journals Oropharyngeal Administration of Colostrum Increases Salivary Secretory IgA Levels in Very Low-Birth-Weight Infants

2017 ◽  
Vol 34 (14) ◽  
pp. 1389-1395 ◽  
Author(s):  
Coleen Greecher ◽  
Kim Doheny ◽  
Kristen Glass
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Multicenter Trial ◽  
Secretory Iga ◽  
Control Group ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Late Onset Sepsis

Aim Oropharyngeal administration of colostrum (OAC) has been proposed to provide mother's early milk to very low-birth-weight (VLBW) infants in the first few days of life. The aim of this study was to test the hypothesis that OAC would increase salivary secretory IgA (SsIgA). Patients and Methods Overall, 30 VLBW infants randomized to receive OAC or sterile water had salivary sampling for SsIgA on the day of life (DOL) 2, 7, and 14. The incidence of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) was determined prospectively. Within and between-group comparisons were made by paired and independent samples t-tests. Results Baseline characteristics were similar between groups. SsIgA was higher in OAC versus the control group (p < 0.05) on DOL 7, but not subsequently on DOL 14. There was no difference in LOS or NEC. Conclusion OAC increased SsIgA at DOL 7. A large, multicenter trial is needed to determine if OAC decreases LOS or NEC in VLBW infants.

scholarly journals Clinical and vital sign changes associated with late-onset sepsis in very low birth weight infants at 3 NICUs

2021 ◽  
pp. 1-9
Author(s):  
B.A. Sullivan ◽  
V.P. Nagraj ◽  
K.L. Berry ◽  
N. Fleiss ◽  
A. Rambhia ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Cross Correlation ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Clinical Signs ◽  
Baseline Risk ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Late Onset Sepsis

BACKGROUND: In premature infants, clinical changes frequently occur due to sepsis or non-infectious conditions, and distinguishing between these is challenging. Baseline risk factors, vital signs, and clinical signs guide decisions to culture and start antibiotics. We sought to compare heart rate (HR) and oxygenation (SpO2) patterns as well as baseline variables and clinical signs prompting sepsis work-ups ultimately determined to be late-onset sepsis (LOS) and sepsis ruled out (SRO). METHODS: At three NICUs, we reviewed records of very low birth weight (VLBW) infants around their first sepsis work-up diagnosed as LOS or SRO. Clinical signs prompting the evaluation were determined from clinician documentation. HR-SpO2 data, when available, were analyzed for mean, standard deviation, skewness, kurtosis, and cross-correlation. We used LASSO and logistic regression to assess variable importance and associations with LOS compared to SRO. RESULTS: We analyzed sepsis work-ups in 408 infants (173 LOS, 235 SRO). Compared to infants with SRO, those with LOS were of lower GA and BW, and more likely to have a central catheter and mechanical ventilation. Clinical signs cited more often in LOS included hypotension, acidosis, abdominal distension, lethargy, oliguria, and abnormal CBC or CRP (p <  0.05). HR-SpO2 data were available in 266 events. Cross-correlation HR-SpO2 before the event was associated with LOS after adjusting for GA, BW, and postnatal age. A model combining baseline, clinical and HR-SpO2 variables had AUC 0.821. CONCLUSION: In VLBW infants at 3-NICUs, we describe the baseline, clinical, and HR-SpO2 variables associated with LOS versus SRO.

scholarly journals Procalcitonin as a Screening Test for Late-Onset Sepsis in Preterm Very Low Birth Weight Infants

2005 ◽  
Vol 25 (6) ◽  
pp. 397-402 ◽  
Author(s):  
Ramesh Vazzalwar ◽  
Estela Pina-Rodrigues ◽  
Bhagya L Puppala ◽  
Denise B Angst ◽  
Lorene Schweig
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Screening Test ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Low Birth Weight Infants ◽  
Late Onset Sepsis

Clinicopathological Differences Between Early-onset and Late-onset Sepsis and Pneumonia in Very Low Birth Weight Infants

1990 ◽  
Vol 10 (5) ◽  
pp. 757-768 ◽  
Author(s):  
Kyoko Itoh ◽  
Hiroaki Aihara ◽  
Satoshi Takada ◽  
Masamitsu Nishino ◽  
Yokei Lee ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Early Onset ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Low Birth Weight Infants ◽  
Late Onset Sepsis

scholarly journals Nutritional Factors Associated with Late-Onset Sepsis in Very Low Birth Weight Newborns

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 196
Author(s):  
Juliany Caroline Silva de Sousa ◽  
Ana Verônica Dantas de Carvalho ◽  
Lorena de Carvalho Monte de Prada ◽  
Arthur Pedro Marinho ◽  
Kerolaynne Fonseca de Lima ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Growth Restriction ◽  
Low Birth Weight Infants ◽  
Late Onset Sepsis ◽  
Extrauterine Growth Restriction

Background: Delayed onset of minimal enteral nutrition compromises the immune response of preterm infants, increasing the risk of colonization and clinical complications (e.g., late-onset sepsis). This study aimed to analyze associations between late-onset sepsis in very low birth weight infants (<1500 g) and days of parenteral nutrition, days to reach full enteral nutrition, and maternal and nutritional factors. Methods: A cross-sectional study was carried out with very low birth weight infants admitted to a neonatal intensive care unit (NICU) of a reference maternity hospital of high-risk deliveries. Data regarding days of parenteral nutrition, days to reach full enteral nutrition, fasting days, extrauterine growth restriction, and NICU length of stay were extracted from online medical records. Late-onset sepsis was diagnosed (clinical or laboratory) after 48 h of life. Chi-squared, Mann–Whitney tests, and binary logistic regression were applied. Results: A total of 97 preterm infants were included. Of those, 75 presented late-onset sepsis with clinical (n = 40) or laboratory (n = 35) diagnosis. Maternal urinary tract infection, prolonged parenteral nutrition (>14 days), and extrauterine growth restriction presented 4.24-fold, 4.86-fold, and 4.90-fold higher chance of late-onset sepsis, respectively. Conclusion: Very low birth weight infants with late-onset sepsis had prolonged parenteral nutrition and took longer to reach full enteral nutrition. They also presented a higher prevalence of extrauterine growth restriction than infants without late-onset sepsis.

scholarly journals Late onset sepsis and intestinal bacterial colonization in very low birth weight infants receiving long-term parenteral nutrition

2011 ◽  
Vol 44 (4) ◽  
pp. 447-450 ◽  
Author(s):  
Priscila Castro Cordeiro Fernandes ◽  
Elias Jose Oliveira von Dolinger ◽  
Vânia Olivetti Steffen Abdallah ◽  
Daiane Silva Resende ◽  
Paulo Pinto Gontijo Filho ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Central Venous Catheter ◽  
Parenteral Nutrition ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Venous Catheter ◽  
Central Venous ◽  
Low Birth Weight Infants ◽  
Late Onset Sepsis

INTRODUCTION: The purpose of this study was to establish the late onset sepsis (LOS) rate of our service, characterize the intestinal microbiota and evaluate a possible association between gut flora and sepsis in surgical infants who were receiving parenteral nutrition (PN). METHODS: Surveillance cultures of the gut were taken at the start of PN and thereafter once a week. Specimens for blood culture were collected based on clinical criteria established by the medical staff. The central venous catheter (CVC) tip was removed under aseptic conditions. Standard laboratory methods were used to identify the microorganisms that grew on cultures of gut, blood and CVC tip. RESULTS: 74 very low birth weight infants were analyzed. All the infants were receiving PN and antibiotics when the gut culture was started. In total, 21 (28.4%) infants experienced 28 episodes of LOS with no identified source. Coagulase negative staphylococci were the most common bacteria identified, both in the intestine (74.2%) and blood (67.8%). All infections occurred in patients who received PN through a central venous catheter. Six infants experienced episodes of microbial translocation. CONCLUSIONS: In this study, LOS was the most frequent episode in neonates receiving parenteral nutrition who had been submitted to surgery; 28.6% of this infection was probably a gut-derived phenomenon and requires novel strategies for prevention.

scholarly journals Human milk oligosaccharides and their association with late-onset neonatal sepsis in Peruvian very-low-birth-weight infants

2020 ◽  
Vol 112 (1) ◽  
pp. 106-112
Author(s):  
Victor D Torres Roldan ◽  
Meritxell Urtecho S ◽  
Julia Gupta ◽  
Chloe Yonemitsu ◽  
Cesar P Cárcamo ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Human Milk ◽  
Neonatal Sepsis ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Human Milk Oligosaccharides ◽  
Low Birth Weight Infants ◽  
Milk Samples ◽  
Late Onset Sepsis

ABSTRACT Background Oligosaccharides are the third most abundant component in human milk. They are a potential protective agent against neonatal sepsis. Objectives We aimed to explore the association between human milk oligosaccharides (HMOs) and late-onset sepsis in very-low-birth-weight infants, and to describe the composition and characteristics of HMOs in Peruvian mothers of these infants. Methods This is a secondary data analysis of a randomized clinical trial. We conducted a retrospective cohort study of mothers and their very-low-birth-weight (&lt;1500 g) infants with ≥1 milk sample and follow-up data for &gt;30 d. HMOs were measured by high performance liquid chromatography (HPLC). We used factor analysis and the Mantel–Cox test to explore the association between HMOs and late-onset neonatal sepsis. Results We included 153 mother–infant pairs and 208 milk samples. Overall, the frequency of the secretor phenotype was 93%. Secretors and nonsecretors were defined by the presence and near-absence of α1-2-fucosylated HMOs, respectively. The most abundant oligosaccharides were 2'-fucosyllactose, lacto-N-fucopentaose (LNFP) I, and difucosyllacto-N-tetraose in secretors and lacto-N-tetraose and LNFP II in nonsecretors. Secretors had higher amounts of total oligosaccharides than nonsecretors (11.45 g/L; IQR: 0.773 g/L compared with 8.04 g/L; IQR: 0.449 g/L). Mature milk samples were more diverse in terms of HMOs than colostrum (Simpson's Reciprocal Diversity Index). We found an association of factor 3 in colostrum with a reduced risk of late-onset sepsis (HR: 0.63; 95% CI: 0.41, 0.97). Fucosyl-disialyllacto-N-hexose (FDSLNH) was the only oligosaccharide correlated to factor 3. Conclusions These findings suggest that concentrations of different HMOs vary from one individual to another according to their lactation period and secretor status. We also found that FDSLNH might protect infants with very low birth weight from late-onset neonatal sepsis. Confirming this association could prove 1 more mechanism by which human milk protects infants against infections and open the door to clinical applications of HMOs. This trial was registered at clinicaltrials.gov as NCT01525316.

Sepsis and Mortality Prediction in Very Low Birth Weight Infants: Analysis of HeRO and nSOFA

2021 ◽  
Author(s):  
Angela C. Zeigler ◽  
John E. Ainsworth ◽  
Karen D. Fairchild ◽  
James L. Wynn ◽  
Brynne A. Sullivan
Keyword(s):  
Birth Weight ◽  
Blood Culture ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Mortality Prediction ◽  
Blood Cultures ◽  
Low Birth Weight Infants ◽  
Vlbw Infants ◽  
Prediction Of Mortality

Objective Scores to predict sepsis or define sepsis severity could improve care for very low birth weight (VLBW) infants. The heart rate characteristics (HRC) index (HeRO score) was developed as an early warning system for late-onset sepsis (LOS), and also rises before necrotizing enterocolitis (NEC). The neonatal sequential organ failure assessment (nSOFA) was developed to predict sepsis-associated mortality using respiratory, hemodynamic, and hematologic data. The aim of this study was to analyze the HRC index and nSOFA near blood cultures in VLBW infants relative to diagnosis and sepsis-associated mortality. Study Design Retrospective, single-center study of VLBW infants from 2011 to 2019. We analyzed HRC index and nSOFA around blood cultures diagnosed as LOS/NEC. In a subgroup of the cohort, we analyzed HRC and nSOFA near the first sepsis-like illness (SLI) or sepsis ruled-out (SRO) compared with LOS/NEC. We compared scores by diagnosis and mortality during treatment. Results We analyzed 179 LOS/NEC, 93 SLI, and 96 SRO blood culture events. In LOS/NEC, the HRC index increased before the blood culture, while nSOFA increased at the time of culture. Both scores were higher in nonsurvivors compared with survivors and in LOS/NEC compared with SRO. The nSOFA 12 hours after the time of blood culture predicted mortality during treatment better than any other time point analyzed (area under the curve 0.91). Conclusion The HRC index provides earlier warning of imminent sepsis, whereas nSOFA after blood culture provides better prediction of mortality. Key Points

scholarly journals Role of Neutrophil CD64 Index as a Screening Marker for Late-Onset Sepsis in Very Low Birth Weight Infants

PLoS ONE ◽  
2015 ◽  
Vol 10 (4) ◽  
pp. e0124634 ◽  
Author(s):  
Florian Kipfmueller ◽  
Jessica Schneider ◽  
Julia Prusseit ◽  
Ioanna Dimitriou ◽  
Berndt Zur ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Low Birth Weight Infants ◽  
Neutrophil Cd64 ◽  
Late Onset Sepsis ◽  
Screening Marker

scholarly journals Late-Onset Sepsis in very Low Birth Weight Infants: A Brazilian Neonatal Research Network Study

2014 ◽  
Vol 60 (6) ◽  
pp. 415-421 ◽  
Author(s):  
L. M. S. de Souza Rugolo ◽  
M. R. Bentlin ◽  
M. Mussi-Pinhata ◽  
M. F. B. de Almeida ◽  
J. M. d. A. Lopes ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Research Network ◽  
Low Birth Weight Infants ◽  
Late Onset Sepsis
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