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At least 19 recordsLinked to original sources
PubMed2025

Examining Transcriptomic Markers Associated With Neutrophil Extracellular Traps to Predict Mortality Risk in Neonatal Sepsis.

BACKGROUND: Neonates are highly susceptible to sepsis, which is often accompanied by fatal coagulopathy. Anticoagulant therapies have not reduced sepsis-related mortality in clinical trials, possibly due to patient heterogeneity. Neutrophil extracellular traps (NETs) enhance coagulation by activating platelets, suggesting that NET-specific biomarkers may identify patients who may benefit from targeted anticoagulant treatment. This study evaluated the association between NET gene expression and adverse outcomes in neonatal sepsis. METHODS: We analyzed whole blood transcriptomes from 123 neonates with sepsis and developed a predictive model, the NET score, based on NET-related gene expression. Model performance was assessed in two independent validation sets. Mediation and correlation analyses explored the relationship between the NET score and a coagulation score. Temporal transcriptomic data from septic shock cases further tested this interaction. RESULTS: The NET score achieved AUCs of 88.7% and 85.4% in validation Sets 1 and 2, respectively, indicating strong predictive performance. Mediation and temporal analyses supported a sequential relationship between NETosis and coagulation in sepsis. Age-specificity of the model was confirmed using pediatric (n = 163) and adult (n = 86) sepsis transcriptomic datasets. Neonates with disseminated intravascular coagulation exhibited a trend toward elevated NET scores. CONCLUSIONS: Our findings support a novel risk stratification approach using the NET score to identify neonates at increased risk for sepsis-associated coagulopathy and poor outcomes, potentially guiding targeted therapeutic strategies.

neonatal sepsis↗
PubMed1979

Neonatal sepsis.

A review of neonatal sepsis, based on 30 recent cases is presented. After analyzing their personal experiences, the authors review the etiopathogeny (higher incidence in small-for-date, preterm, postterm and in some macrosomic newborns; predominance of gram-negative germs), the importance of early diagnosis, and correct treatment, adapting the antibiotherapy to the bacteriological flora of the location at the time of treatment.

Humans↗
PubMed1977

Neonatal sepsis at The Johns Hopkins Hospital, 1969-1975: bacterial isolates and clinical correlates.

The experience with neonatal sepsis at The Johns Hopkins Hospital during 1969-1975 was reviewed. Major pathogens included Escherichia coli, group B streptococcus, other streptococci, and Klebsiella. Nineteen percent of coliform isolates were kanamycin-resistant. The frequency of recovery of E. coli was increased in early-onset sepsis, and the frequency of recovery of Klebsiella was increased in late-onset sepsis. The mortality rate was 23%. The frequency of recovery of E. coli was increased in fatal cases, and mortality was highly correlated with the presence of gastrointestinal catastrophe. Ampicillin and gentamicin are the initial antibiotics of choice for neonatal sepsis at this institution; a penicillinase-resistant penicillin should be added when Staphylococcus aureus involvement is likely, and addition of chloramphenicol or clindamycin should be considered for infants at increased risk for Bacteroides fragilis sepsis.

Escherichia coli Infections↗
PubMed1979

Urine culture in the evaluation of suspected neonatal sepsis.

Clinical records of patients in a neonatal intensive care unit were reviewed to determine the efficacy of obtaining a urine culture in the detection of neonatal sepsis. During a 12-month period, 188 sets of concomitant blood and urine cultures were obtained in infants less than 72 hours of age (early onset group) and 189 sets of cultures in infants over 72 hours of age (late onset group). Blood cultures were positive in nine instances in the early onset group and 11 instances in the late onset group. All but one blood culture in each group was accompanied by a negative urine culture. Urine cultures alone were positive in two instances in the early onset group and 13 instances in the late onset group (P less than 0.05). Symptoms did not differentiate infants with bacteremia from infants with bacteruria. Culture of the urine was shown to be necessary for the detection of a significant number of late onset infections. Urine culture in the early onset age group had a significantly lower yield, and the risk of suprapubic bladder tap in this group may not be justified.

Bacterial Infections↗
PubMed1976

Obstetric observations in eleven cases of neonatal sepsis due to the group B beta hemolytic streptococcus.

Neonatal sepsis due to Group B streptococcus is reported to be increasing, but the reasons are unclear. Eleven cases from a single hospital were reviewed for common obstetric factors. Frequent observations associated with 8 surviving infants were maternal infection, early evaluation and treatment of the newborn, and 4+ or 5+ growth on maternal cultures. In contrast, mothers of the 3 infants who died had no clinical signs of infection, and cultures were not obtained. All 11 infants had direct monitoring during labor but the frequency of infection, 1/1600 live births, was lower than usually reported. Three surviving infants and 3 nonsurvivors were premature. Semiquantitative culture technics suggest that the predominance of Group B streptococcus in the vagina may be a more important etiologic factor than the frequency of its presence.

Female↗
PubMed1977

Increased incidence of gram-negative neonatal sepsis with intramuscula iron administration.

During a five-year period the incidence of neonatal sepsis was 20 times higher in Polynesian newborns compared with European newborns (11 per 1,000 vs. 0.6 per 1,000 total births). This high incidence in Polynesians was confined to a period when the infants were being given intramuscular iron dextran. When the iron administration was stopped the incidence of disease in Polynesians decreased from 17 per 1,000 to 2.7 per 1,000 total births. An analysis of the Polynesian iron-treated and non-iron-treated groups showed a statistically significant difference in the incidence of sepsis, the type of causative organism, and mortality. The data suggest that the iron dextran injections have impaired the immunity of the treated infants, making them more susceptible to Escherichia coli sepsis.

Bacterial Infections↗
PubMed1979

The protective effect of acute phase reactants in neonatal sepsis.

Phase reactants were evaluated prospectively in babies suspected of having sepsis. Among 318 babies, there were 22 proven and 10 "very probable" cases of neonatal sepsis. Of the proven cases 14 survived and 8 died. The survivors had a positive latex C-reactive protein (CRP) in 11 cases and an alpha1-acid glycoprotein (AGP) level greater than 0.5 g/l in 12 cases. Among those who died, one had a positive latex CRP and none had AGP greater than 0.5 g/l. These findings were supported by positive CRP and elevated AGP in almost all "very probable" cases, all of whom survived. These data in newborn infants support the hypothesis that acute phase reactants have a functional role in combating infection.

C-Reactive Protein↗
PubMed1979

Endometritis and neonatal sepsis due to Streptococcus pneumoniae.

Attention is called to the rarely described clinical entity of pneumococcal infection involving both mother and neonate. A case is described in which neonatal sepsis and puerperal endometritis were documented by isolating Streptococcus pneumoniae type 3 from both mother and child. Clinical implications and a review of relevant literature are briefly discussed.

Adolescent↗
PubMed1978

Group B streptococci in pharyngeal aspirates at birth and the early detection of neonatal sepsis.

The pharyngeal aspirates collected from 400 babies at the time of delivery were examined for the presence of bacteria, especially group B streptococci. Aspirates from 79 babies were found to contain viable bacteria, including 4 with group B streptococci; one of these 4 babies developed streptococcal meningitis within 24 hours. The group B streptococci were seen on a Gram-stained film of the aspirate, and were detectable by coagglutination and countercurrent immunoelectrophoresis within 4 hours and by culture after 24 hours. Examination of pharyngeal aspirates may be of value as a screening test for neonatal sepsis.

Delivery, Obstetric↗
PubMedDate not supplied

[Early onset group B streptococcal neonatal sepsis (author's transl)].

Seventy one per cent of neonates had a gestational age longer than 37 weeks. Sixteen showed respiratory distress, and shock occured in twelve cases. The onset of illness happened within the first 12 hours of life, in 15 cases. No differences were observed among preterm and term infants. Differential leukocyte count were altered in all infants, being particularly relevant the fact that the relation between immature neutrophil/total neutrophil, was elevated in 50 per cent of cases. Mortality rate was 52 per cent. Clinical alert and early treatment with penicillin, together with the use of fresh blood exchange transfusion, can be considered useful methods in the treatment of these cases.

Humans↗
PubMed1978

Bacterial flora of the parturient vagina--implications for neonatal sepsis.

A bacteriological study of vaginal swabs taken from 78 parturient women at Lagos University Teaching Hospital (L.U.T.H.) is presented. 26.83% of the vaginal cultures were sterile. The most frequently isolated bacteria were Staphylococcus spp. 21.4%, followed by beta hemolytic streptococci 16.65%, of which approximately a half belonged to Lancefield group B. Escherichia coli was isolated in 11.1% of the cases. The implications for neonatal and puerperal sepsis are discussed.

Female↗
PubMed1975

Neonatal sepsis. A survey of eight year's experience at the Louisville General Hospital.

Information from 50 infants with neonatal septicemia from the Louisville General Hospital during an eight-year period (1964-1972) is presented. Twenty-five infants had gram-positive and the other 25 had gram-negative organisms. E. coli (13 cases), staphylococcus (10 cases), and hemolytic Streptococcus non-Group A (7 cases) were the mustcommon causative microorganisms. Only one of the 25 infants with gram-positive sepsis died; three with gram-negative sepsis died. Listeria monocytogenes was demonstrated in three infants; all had meningitis with no mortality. Early diagnosis, prompt intensive antibacterial therapy, and a high index of suspicion are most helpful for reducing the morbidity and mortality.

Blood↗
PubMed1976

Fulminant neonatal sepsis and necrotizing enterocolitis associated with a "nonenteropathogenic" strain of Escherichia coli.

During 1973 a nonendemic mucoid strain of Escherichia coli entered the nursery of a hospital in Houston. This organism caused septicemia and was associated with a high incidence of necrotizing enterocolitis. The illness was fulminant and characterized by apnea, abdominal distension, and shock. Diarrhea was not a feature of the symptom complex. The epidemic organism was nontypable. Assays for invasiveness, enterotoxin production, and Kl antigen were negative. Surveillance revealed a colonization rate of 14%, an attack rate in colonized infants of 19.5%, and a mortality rate of 87.5%. These data suggest that in certain instances the specific bowel flora may increase the incidence and severity of NEC.

Disease Outbreaks↗
PubMed1976

Pulmonary changes in neonatal sepsis to group B beta-hemolytic Streptococcus: relation of hyaline membrane disease.

The radiographic changes of hyaline membrane disease were seen in seven of eight infants with group B beta-hemolytic streptococcal sepsis. Hyaline membranes were found throughout the lungs of all six infants who were examined after death. The most striking finding was the presence of group B streptococci within the membranes of five infants. Streptococci were so numerous in one instance that they comprised the bulk of the membrane. Another infant uas thought to have classical hyaline membrane disease until numerous group B streptococci were found within the membranes when lung sections were examined with special stains. No other organisms were identified within the membranes of any infant. These findings suggest that infection with group B streptococcus may cause a syndrome clinically and radiologically indistinguishable from hyaline membrane disease.

Female↗
PubMed1977

The radiographic features of early onset Group B streptococcal neonatal sepsis.

The clinical and radiographic features of 27 newborn infants with early onset Group B streptococcal infection as documented by blood culture have been reviewed. Initial chest radiographs revealed a wide spectrum of patterns. These included changes usually associated with the respiratory distress syndrome, extensive pneumonia, and small infiltrates as well as a normal appearance. Premature birth and a fatal outcome were associated with extensive radiographic changes. At autopsy some of the infants with a radiographic appearance of respiratory distress syndrome had pathologic features of Group B streptococcal infection with no apparent evidence of coexisting respiratory distress syndrome.

Humans↗