Category: Infections

Post-immunization cardiorespiratory events in preterm infants

A randomized trial in infants less than 32 weeks gestation at birth compared changes in levels of C-reactive protein, prostaglanding E2 (PGE2) and the frequency of cardio-respiratory events after the infants received the two-month vaccinations. The intervention group received ibuprofen…

Zika virus guideline

Updated guidelines from the CDC recommend Zika virus testing for infants born to mothers who have laboratory features of  exposure to Zika virus and to infants who have clinical features of infection (microcephaly, intracranial calcifications, eye anomalies and other neurologic…

How long should we treat for CMV infection?

A randomized trial in almost 100 infants with symptomatic congenital cytomegalovirus infection compared the effects of treatment with valganciclovir for six months versus six weeks. The primary outcome of hearing in the better ear did not change significantly from baseline…

Changes in intestinal microbiome prior to onset of NEC

A case control study evaluated the patterns of the intestinal microbiome prior to the development of NEC in 12 infants and compared these with the patterns in 26 control infants without NEC. Fecal samples were collected from all these infants…

Impact of routine surveillance for MRSA

A single-center study reported the results two years before and two years after routine MRSA surveillance was introduced. The rate of MRSA blood-stream infection was 3.8 per 1000 neonates in the pre-surveillance period and 5.3 per 1000 neonates during the…

Vancomycin dosing regimens – validation needed

A prospective observational study of vancomycin trough levels using two different dosing regimens in over 200 neonates found that vancomycin trough levels of less than 10 mg/L were quite common (70% of trough levels were below this level). These suboptimal…

MRSA colonization and risk of infection

A systematic review of studies that reported the prevalence of MRSA colonization on admission to the NICU and PICU, and of MRSA infection, found that the overall prevalence of colonization on admission was 2%. In the NICU, around 6% of…

Time to culture positivity in infants less than 90 days

A retrospective study of infants aged 0 to 90 days who were evaluated for serious bacterial infection looked at the time to detection of positive blood, urine and cerebrospinal fluid cultures. Positive cultures were identified in less than 36 hours…

Fluconazole prophylaxis: a randomized trial

A randomized blinded multicenter trial studied the effects of prophylactic fluconazole in babies less than 750 grams birth weight. Fluconazole (6 mg/kg/day) was given twice a week for 42 days. Control infants received placebo. The composite primary end point of…

Antimicrobial prophylaxis with VUR

A multicenter randomized trial (the RIVUR trial) in infants and children (no neonates were included) with vesico-ureteric reflux compared the effects of prophylaxis with cotrimoxazole versus placebo on the rate of recurrent urinary tract infection, renal scarring, treatment failure (a…

Preventing GBS infection using a smartphone app

The Centers for Disease Control (CDC) has just released a smartphone app to help prevent infections with Group B Streptococcus by enabling obstetric and neonatal health professionals manage mothers and newborns according to the 2010 CDC guidelines. The app allows users to…

Probiotics in very preterm infants

A randomized trial in babies less than 32 weeks gestation and less than 1500 grams compared the use of probiotics to placebo. Over 1000 babies were studied. Overall breast milk usage rate was high (>95%) in both arms. Babies in…

Purchasing human milk on the internet

Breast milk can be purchased directly through special websites without human milk bank involvement. Investigators from Ohio obtained around 100 breast milk samples from two such sites and cultured the milk. Almost three quarters of them had either Gram negative…

Eliminating delays in antibiotic administration

A single-center report describes the results of a quality improvement project aiming to shorten the interval between an antibiotic order and actual administration of the antibiotic to less than two hours in neonates with suspected late-onset sepsis. Through iterative cycles and…

Treating Coagulase-negative Staph – is a three-day course enough?

In a NICU in the Netherlands the duration of treatment for Coagulase-negative Staphylococcal sepsis was changed from seven days to three days, provided that there was clinical improvement within 48 h, the CRP value decreased, the platelet count was normal, and…

MRSA and MSSA in preterm infants

A study from the NICHD Neonatal Research Network describes the frequency and impact of infections with MRSA and with methicillin-sensitve staph aureus (MSSA) in VLBW infants. One percent of all infants had a MRSA infection. MRSA infections varied across centers…

Catheter-related sepsis in ELBW infants

In a retrospective cohort study from Canadian NICUs of babies less than 29 weeks gestation or less than 1000 grams birth weight who had a percutaneously placed central venous catheter, around 20% of babies developed catheter-related sepsis. The rate of…