Risk Factors for Neonatal Sepsis and Method for Reduction of Blood Culture Contamination.

BACKGROUND: False-positive blood cultures findings may lead to a falsely increased morbidity and increased hospital costs. METHOD: The survey was conducted as retrospective - prospective study and included 239 preterm infants (born before 37 weeks of gestation) who were treated in Neonatal Intensive Care Unit (NICU) in Institute for Child and Youth Health Care of Vojvodina during one year (January 1st, 2012 to December 31st, 2012). The retrospective part of the study focused on examination of incidence of neonatal sepsis and determination of risk factors. In the prospective part of the study infants were sub-divided into two groups: Group 1- infants hospitalized in NICU during the first 6 months of the study; blood cultures were taken by the "clean technique" and checklists for this procedure were not taken. Group 2- neonates hospitalized in NICU during last 6 months of the study; blood cultures were taken by "sterile technique" and checklists for this procedure were taken. RESULTS: The main risk factors for sepsis were prelabor rupture of membranes, low gestational age, low birth weight, mechanical ventilation, umbilical venous catheter placement, and abdominal drainage. Staphylococcus aureus and coagulase negative Staphylococcus were the most frequently isolated microorganisms in false-positive blood samples. CONCLUSIONS: Education of employees, use of checklists and sterile sets for blood sampling, permanent control of false positive blood cultures, as well as regular and routine monthly reports are crucial for successful reduction of contamination rates.

[Treatment of respiratory infections in children]. / Lecenje respiracionih infekcija kod dece.

Review of respiratory infection farmacotherapy is presented in the paper. It is emphasised that the inital therapy bacterial pneumonia is related to age of the child. The role and importance of ribavirin and specific immunoglobulin in the treatment of acute bronchiolitis caused by RSV is stressed. Also, positive influence of immunostimulators as a possibility for prevention of repeated bronchitic attacks is explained. In the treatment of chronic pulmonary disease in cystic fibrosis antibiotic therapy along with physical therapy is of a crucial importance. The use of amiloride, proteinase inhibitors and DN-ase by inhalation offer hopeful results in treating pulmonary disease in cystic fibrosis. Symptomatic therapy, physical therapy, general measures, care and nutrition have very important role in treatment of the respiratory infections.

[Psychomotor development in children born with anoxia--perinatal risk factors]. / Psihomotorni razvoj dece rodene u anoksiji--perinatalni faktori rizika.

In 1989 a control of psychomotor development was conducted in 318 children born with the Apgar score of 7 and less. The children controlled were of the age of 3 months to 6.5 years old. Clinical examination and the testing of children of up to the age of one year according to Brunet Lezin have shown a decrease in the number of points of nine children (4.05%). The finding points to a deviation in psychomotor development of a mild degree. Out of 80 preschool children, 8% of them had clinically evident signs of a possible cortical lesion, which were discreet and regarded the visuomotor, in other words visuoconstructive functions.

[Asphyxia and intracranial hemorrhage in high-risk neonates of various gestational ages]. / Asfiksija i intrakranijalno krvarenje kod vitalno ugrozene novorodencadi razlicite gestacione dobi.

The aim of this study was to compare the type and severeness of brain damage in vitally most endangered newborn infants of different gestational age. We retrospectively analyzed the records of 75 newborn infants treated and decreased at the Department of Intensive Care and Therapy of the Institute of Children's and Adolescents' Health Care in Novi Sad. Diagnoses of hypoxic-ischemic lesion and intracranial hemorrhage in the case of grade four PVH-IVH (periventricular hemorrhage-intraventricular hemorrhage) were established by ultrasonography of the brain and lumbar punction in the case of subarachnoid hemorrhage. These diagnoses were confirmed after forensic-medical expertise. The volume and degree of the damage were compared in regard to the gestational age, Apgar score and time of initial mechanical ventilation and initial parameters of the mechanical ventilation, as well as to values of acido-basic status, concentration of gases in arterialized capillary blood and type of lung damage which always occurred in these patients. In all 75 examined newborns perinatal asphyxia was the dominant etiologic factor for the course and outcome of the disease (in all patients Apgar score was 4 or less). 75% of examines were born before 32 weeks gestation and of low or very low body weight, whereas 72% had intracranial hemorrhage (periventricular-intraventricular) and hypoxic-ischemic damage of the brain parenchyma. The rest of examinees had intracranial hemorrhage or hypoxic-ischemic damage of the brain parenchyma. Although 92% of examinees received mechanical ventilation in the first 3 days of life, only 20% of newborn infants had satisfactory values of acido-basic status and gas concentrations in the blood. We concluded that in the most severe cases of perinatal asphyxia, especially in preterm newborns of low or very low body weight, both intracranial hemorrhage and hypoxic-ischemic encephalopathy develop. Damages of other organs or systems of organs, especially lungs, as a rule contribute to infaust ending.