Globe calcification in congenital toxoplasmosis.

Various patterns of distribution of intracerebral calcification have been described in congenital toxoplasmosis. We report a case of congenital toxoplasmosis with a rare finding of calcification in the globe detected by CT scan that has not been described earlier.

Neonatal Group B Streptococcal bacteraemia in India: ten years' experience.

Group B Streptococcus (GBS) is an infrequent cause of neonatal septicaemia in many developing countries. In a perinatal centre in India with 60,119 live births between 1988 and 1997, GBS was isolated from blood cultures of 10 babies. Thus the incidence of GBS bacteraemia was 0.17 per 1000 live births. Lethargy, respiratory distress and poor perfusion were the presenting features in eight symptomatic babies. Two babies had meningitis, three required ventilatory support and one died. There were no cases of late onset disease. The low incidence could be due to the low rate of colonisation and high prevalence of protective antibody in the mothers.

Randomized controlled trial of once vs. twice daily gentamicin therapy in newborn.

OBJECTIVE: To compare the efficacy of once daily gentamicin administration to the conventional twice daily dosage schedule by estimation of serum gentamicin concentrations (SGC) in neonates. DESIGN: Randomized controlled trial. SETTING: Medical college hospital. SUBJECTS: Seventy three neonates of gestational age>32 weeks at risk or with clinical features of sepsis. METHODS: The subjects were divided into preterm and term groups. Babies in each of these groups were randomized to receive a single daily dose (4 mg/kg) or a twice daily dose (2.5 mg/kg) of injection gentamicin intravenously. Trough and peak SGC were estimated half an hour prior and one hour after the second dose. Statistical analysis was done using the equivalence method. RESULTS: In preterm as well as term babies, the mean peak and trough gentamicin levels were comparable in the two regimens. There is statistically significant evidence to show that the effect of once daily and twice daily dosage is similar. CONCLUSION: Once daily gentamicin administration is as effective as twice daily therapy and would be more cost effective.

Bacterial profile of sepsis in a neonatal unit in south India.

OBJECTIVE: To study the pattern of sepsis in a neonatal unit in south India and assess the influence of maternal factors on early onset sepsis (EOS). DESIGN: Prospective survey from 1995-1996. SETTING: Medical College Hospital. SUBJECTS: All inborn babies who had clinical signs of sepsis or were born to mothers with potential risk factors for infection were screened for sepsis. Neonatal septicemia was defined as a disease of infants who were younger than 1 month of age, were clinically ill, and had positive blood cultures. RESULTS: Among 13,367 live births in the study period, there were 131 episodes of neonatal septicemia among 125 newborn infants, 18 (14.4%) of whom died. Thirty (24%) had EOS (< or = 48 hours) and 95 (76%) had late onset sepsis (LOS) (> or = 48 hours). Sepsis occurred in 9.8 per 1000 livebirths and 4.4% of all nursery admissions. E. coli and E. fecalis were the predominant organisms causing EOS, while Klebsiella and E. fecalis were the predominant organisms in LOS. The mean gestational age (GA) and birth weight (BW) of babies with EOS was significantly higher than those with LOS. Maternal factors significantly associated with EOS were meconium staining of liquor and multiple vaginal examinations. CONCLUSIONS: The incidence of neonatal bacterial sepsis is 9.8 per 1000 livebirths. E. coli and Klebsiella were the most common organisms causing EOS and LOS, respectively. E. fecalis was also a major pathogen, both in EOS and LOS.