Comparison of clinical features of purulent meningitis between small-for-gestational-age and appropriate-for-gestational-age infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the differences in the clinical features of purulent meningitis (PM) between small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) infants.</p><p><b>METHODS</b>The clinical data of 58 full-term infants with PM were analyzed retrospectively. The infants were classified into a SGA group (13 cases) and an AGA group (45 cases) according to their birth weight and gestational age. Clinical manifestations, laboratory results, and outcomes were compared between the two groups.</p><p><b>RESULTS</b>The incidence of decreased muscle tone in the SGA group was significantly higher than that in the AGA group (P<0.05); the positive rate in the Pandy's test for cerebrospinal fluid in the SGA group was significantly higher than that in the SGA group (P<0.05). Brain imaging examination showed that the incidence of brain injuries in the SGA group was significantly higher than that in the AGA group (P<0.05).</p><p><b>CONCLUSIONS</b>SGA infants with PM display a higher risk of brain injury, suggesting a poorer outcome, compared with AGA infants.</p>

Urinary tract infections in the neonatal intensive care unit: clinical analysis of 229 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical features, distribution of pathogens, drug susceptibility, and treatment effectiveness in neonates with urinary tract infection (UTI) and admitted to the neonatal intensive care unit (NICU).</p><p><b>METHODS</b>The clinical data of 229 neonates who developed UTI during their stay in the NICU were retrospectively studied.</p><p><b>RESULTS</b>The main clinical manifestations of these children included fever/irregular body temperature, refusing to milk feeding, jaundice, vomiting, diarrhea, poor weight gain, and lethargy. The top three pathogens were Escherichia coli, Enterococcus feces, and Klebsiella pneumoniae. Escherichia coli and Klebsiella pneumoniae were highly resistant to ampicillin and most cephalosporins (≥ 85%), and were highly sensitive to imipenem (100%), meropenem (100%), cefoperazone/sulbactam and piperacillin/tazobactam (>90%). Enterococcus feces were highly resistant to penicillin (100%), rifampicin (84%) and gentamicin (79%), but were sensitive to vancomycin.</p><p><b>CONCLUSIONS</b>The clinical manifestations of neonatal UTI are often atypical and manifested as systemic symptoms. The main pathogenic bacterium is Escherichia coli, and the isolation rate of enterococci can also be high. Most pathogenic bacteria are resistant to penicillin and cephalosporins, and therefore decision-making on drug administration must be based on the results of drug sensitivity tests.</p>