Introduction: Hospital-acquired infections continue to be a major public health problem, especially among neonates. Large proportions of infants are admitted to neonatal intensive care units (NICUs) and receive potent systemic antibiotics while the diagnostic work-up is still in progress. This study aimed to evaluate the recent methods for diagnosing neonatal sepsis (NS) and compare them to conventional diagnostic work-up. Methodology: The study included 100 neonates divided into three groups: proven early-onset NS, clinical early-onset NS, and negative infectious status. Bacterial DNA was detected in the blood by broad-range 16S rDNA polymerase chain reaction (PCR). Markers for diagnosis of bacterial infection, which includedprocalcitonin (PCT), interleukin-6 (IL-6), and highly sensitive C-reactive protein (hs-CRP), were measured by enzyme-linked immunosorbent assay (ELISA). Results: Blood culture was positive in 25 cases, while PCR for 16S rDNA was positive in 32 cases. Hs-CRP was significantly elevated in 30 patients in group 1, 35 patients in group 2, and 8 patients in group 3. IL-6 was significantly elevated in 28 patients in group 1, 24 patients in group 2, and 9 patients in group 3. PCT was found to be significantly elevated in 29 patients in group 1, 31 patients in group 2, and 2 patients in group 3. Conclusions: The16S rDNA PCR assay was more sensitive than blood culture. The combination of markers (hs-CRP, PCT, and IL-6) is better than single markers to diagnose sepsis. PCT had greater diagnostic value than did hs-CRP and IL-6, while IL-6 was better for diagnosis of neonatal infection.

Objectives:To explore the risk factors, the prevalence rate, and gene types of extended-spectrum beta-lactamase (ESBL)-producing bacteria as the causative agents of infection at King Abdulaziz Specialist Hospital (KAASH), Taif, Kingdom of Saudi Arabia.Methods:This was a retrospective study conducted during the period between February 2017 and January 2018. All samples obtained from the KAASH were analyzed. The MicroScan Walkaway System, bacteriological examination and double disk synergy tests were used to detect ESBL-producing bacteria. To identify ESBL genes, the polymerase chain reaction (PCR) technique was used.Results:The ESBL phenotype was detected in 351 of 1151 isolates (30.5%); Escherichia coli (E. coli) (62.7%) and Klebsiella pneumoniae (K. pneumoniae) (23.6%) were the most prevalent. The highest proportion of ESBL specimens was found in urine (62%.5), and these organisms were mainly isolated from the female medical ward (20.2%). Based on the statistical analysis, lung diseases, renal diseases, diabetes and heart diseases contributed to the spread of ESBL infections. Amikacin, imipenem, meropenem and tigecycline were found to be effective in overcoming ESBL infections; however, these antibiotics may be inappropriate for new strains of K.pneumoniae. The distribution of the blaCTX-M gene was high (87%), compared with blaTEM (74.9%) and blaSHV (29.4%).Conclusion:These data provide new epidemiological information about the prevalence of ESBL-producing organisms among patients in KAASH, Taif, Saudi Arabia. In addition, this study identified the clonal nature of isolated E.coli and K.pneumoniae.

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IL-4Rα gene (I50V) and STAT6 gene (G2964) polymorphisms may play a role in development of eczema; however, the IL-4 gene polymorphism (C-590T) had no relationship with susceptibility to the disease among Saudi children.