[Neonatal Salmonella enteritidis infection].
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Biomedical subjects
Publications and source records attributed to M T Esque Ruiz.
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Between 1 May 1984 and 30 April 1985, 1,354 term or posterm neonates being white and having asphyxia in controlled delivery were studied to predict development of neurological signs and its seriousness. In each case correlations were estimated between the existence of neurological signs and its grade and 100 gestational, obstetric and neonatal factors of potential predictor. The discriminatory analysis indicated that the more significants predictors were: Apgar at five minutes, prolonged labor, twins, resuscitation, DIP I, cephalhematoma, caput succedaneum, umbilical artery pH, urgent cesarean section, hemorrhagic amniotic fluid, gestational edema, variable DIP, high forceps. A discriminatory value less than or equal to 2 predicts no neurological sign in 93.8%, while a value greater than or equal to 3 predicts moderate or serious signs is 98.4%.
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We have performed 113 percutaneous catheterization in 87 newborn babies, locating them centrally in 60 cases (53%). In 69 (61%) cases the duration of catheter was as long as desired. Average duration was 14.65 days. No important complications were detected. We think that this in a useful technique that allows a long term circulatory access, even central venous lines. Aseptic procedure is mandatory as well as X-ray control of the distal tip of the catheter.
Among 1,049 admissions in the newborn department, during 18 months, authors found 148 positive blood cultures to staphylococci epidermidis (EPN). Recovery of EPN from blood should not be dismissed as a contaminant. 11 newborn were considered to have septicemia by EPN, that means 1.04% of all admissions and 5.6% of babies admitted in intensive care. They find that catheters (100%), assisted ventilation (45.4%) and previous surgery (36.3%) are significant predisposing risk factors. Clinical and laboratory pattern was not different of other sepsis except its late onset. Two patient died. Vancomycin is considered the drug of choice.
Seven cases of neonatal systemic candidiasis are summarized. This means an incidence of 8.3% respect total amount of newborns admitted and 3.7% of babies admitted in the intensive care unit. Clinical presentation was not specific. Five blood cultures were positive and in two cases meningitis was recognized. Two cases died. Six cases were treated with amphotericin B and 5-fluorocytosine and in one case renal toxicity appear.