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Results for “late-onset sepsis”

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PubMed2025

Bacterial metabolite patterns of infants receiving multi-strain probiotics and risk of late-onset sepsis.

The effect of multi-strain probiotics containing Bifidobacterium longum (B. longum) on late-onset sepsis (LOS) risk in very-low-birth-weight infants (VLBWIs; birth weight < 1,500 g) remains uncertain. In a single-center study, we analyzed intestinal metagenome and metabolome data in VLBWIs during the period of highest vulnerability of LOS. Using a unit's policy change to routinely administer B. longum subspecies infantis plus Lactobacillus acidophilus as natural experiment, we compared 97 infants (including 38 LOS cases) after change with 78 infants (including 32 LOS cases) before. Probiotic supplementation was associated with more beneficial bacteria and reduced abundance of nosocomial pathobionts, such as Klebsiella spp. Infants in the probiotic group had significantly lower concentrations of B. longum fermentation products prior to sepsis diagnosis than matched non-LOS cases (acetate: padj = 0.0049; lactate: padj = 0.048). Modulation of the gut metabolic milieu is an interesting target for LOS prevention.

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↗

PubMed2026

Umbilical Cord-Derived Cell-Based Interventions for Bronchopulmonary Dysplasia and Related Complications in Preterm Infants: A Bayesian Sparse-Data Meta-Analysis.

Bronchopulmonary dysplasia (BPD) is a major complication of prematurity with limited disease-modifying therapies. We evaluated umbilical cord-derived cell-based interventions for BPD and related complications in preterm infants. This Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020-based systematic review and meta-analysis were registered in PROSPERO. PubMed, Cochrane Library, Web of Science, CNKI, and Wanfang were searched from inception to June 14, 2026. Comparative clinical studies of umbilical cord-derived cell-based interventions in preterm infants at risk of or diagnosed with BPD were included. Outcomes included BPD, BPD severity, death, persistent pulmonary hypertension of the newborn (PPHN), patent ductus arteriosus (PDA), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), late-onset sepsis (LOS), and adverse events (AEs). Bayesian random-effects meta-analysis used a binomial-normal hierarchical model to estimate pooled odds ratios (ORs), 95% credible intervals (CrIs), prediction intervals, and heterogeneity. Twelve studies were included. Umbilical cord-derived cell-based interventions showed a possible protective effect on overall BPD (OR, 0.48; 95% CrI, 0.14-1.20). Stronger associations were observed for severe BPD (OR, 0.17; 95% CrI, 0.01-0.85), moderate or severe BPD (OR, 0.28; 95% CrI, 0.09-0.70), and ROP stage ≥3 (OR, 0.17; 95% CrI, 0.02-0.65). No conclusive benefit or harm was observed for death, PPHN, PDA, IVH, NEC, or LOS. No treatment-related serious AEs were identified. However, prediction intervals were generally wide, and the certainty of evidence was low to very low for most outcomes. Umbilical cord-derived cell-based interventions may reduce the risk of moderate or severe BPD in preterm infants, with an additional potential benefit for ROP stage ≥3. Current evidence remains limited, and larger randomized trials with standardized outcomes and long-term follow-up are needed.

Humans↗

PubMed1979

[Group B streptococci: the most common cause of neonatal septicemia (author's transl)].

Between 1965--78 118 newborns with septicemia have been treated in the Children's Hospital of the Free University Berlin. Microorganisms identified were streptococci in 32 cases, 27 of which were group B streptococci (increasing number since 1973). In 1978 group B streptococci were responsible for 44% of all the septicemia cases as well as for 12% of all newborn deaths. The incidence of group B streptococcal septicemia in newborn babies is 1/1000 live births for the Berlin region. 2 patients presented the late-onset type of group B streptococcal neonatal sepsis; both survived having neurological sequelae. 25 newborns belonged to the early-onset group, the mortality rate in this group is 56%. The clinical features, bacteriological findings and risk factors are summarized in table form. There could be an influence related to the maternal blood type. Histological examinations in 5 placentae revealed signs of amniotic infection.

Birth Weight↗

PubMed1977

Neonatal streptococcal infections.

Most serious neonatal streptococcal infections are caused by group-B streptococci. The pattern of serious group-B neonatal disease in Britain resembles that described in other countries; both "early-onset" and "late-onset" forms are seen, but reliable incidence rates have not yet been determined. Serological-type III strains predominate in neonatal meningitis in Britain, but not so markedly as in some parts of the U.S.A. A deficiency of group-II strains in meningitis is, however, apparent in both countries. Present information about the carriage of group-B streptococci suggests that antibiotic prophylaxis administered to mothers or infants is unlikely to reduce greatly the frequency of "early-onset" disease. The continuous presence of a suitable chemical disinfectant in the vagina during labour might be more effective. Insufficient is known about the epidemiology of "late-onset" neonatal disease for rational preventive measures to be designed. More information is required about the postnatal acquisition of group-B streptococci by neonates and its sources, and about passive transfer of type-specific antibody from the mother to her child.

Adolescent↗

PubMed1979

[Complications and survival rate in preterm infants and neonates treated with mechanical ventilation (author's transl)].

Between January 1972 and December 1976 201 preterm infants and neonates were treated with mechanical ventilation. These children were classified into 6 groups according to the indications for mechanical ventilation: P = respiratory failure caused by pulmonary disease; Z-P = respiratory failure caused by cerebral disturbance with simultaneous respiratory disease; Z = respiratory failure caused by cerebral disturbance; C = respiratory failure caused by cardiac disease; SCH = respiratory failure through shock; M = respiratory failure caused by mechanical disturbance; Bronchopulmonary complications developed in 70% of the survivors and in 60% of the fatalities. The most serious bronchopulmonary complications were infections which occured with similar frequency in all indication groups as late-onset complications, and air-leaks which occured as early complications. The latter complication was significantly higher (38%) in the first than in the other groups. The most serious extrapulmonary complications were seizures, intracerebral hemorrhages and septicemia. 71 of the 201 patients survived. There was a significant increase in the survival rate from 21.2% in 1972-1973 to 43% in 1974-1976. The survival rates differed significantly within the indication groups. The best result was found in the p-group followed by the Z-group. The highest mortality rate was found in the SCH and C-group.

Bronchial Diseases↗

PubMed1978

Analysis of group B streptococcal types associated with disease in human infants and adults.

It is important to resolve existing differences of opinion regarding group B streptococcal type distribution in human disease because of the relevance of type prevalence to future programs of prevention. This report compares data obtained from typing 392 group B streptococci isolated from systemic infections in both infants and adults in the United States from 1972 through 1975. The data showed a substantial predominance of type III among strains isolated from cases of infant meningitis and from "late-onset" septicemia but did not confirm a prior report that type Ia causes most cases of "early-onset" infant septicemia. Type II was the predominant serotype among 11 cerebrospinal fluid isolates from adults. The fact that over one-fourth of the isolates were types other than Ia or III means that future epidemiological studies, including definition of immunological factors, must include all five group B types.

Adolescent↗

PubMed1978

Group B streptococcal infection in the perinatal period. An increasing problem in newborn care.

Group B streptococcal infections in newborn infants are increasing in frequency. Infection takes two forms--early-onset, developing in the first 24 hours, and late-onset, developing after the first week. Early-onset disease, a fulminating septicaemia, has a mortality of 40-70%. Late-onset disease, usually meningitis, has a mortality of 20-30%, with a high incidence of neurological damage in survivors. Early-onset disease is acquired during delivery from organisms colonizing the vagina. Up to 25% of women are colonized in late pregnancy. So far, no effective programmes for prevention have been developed.

Diagnosis, Differential↗