No abstract

Jaundice is one of the most common problems in the newborn. It is generally accepted as a physiologic condition; most cases are benign and transient. However, in a small portion of jaundiced newborn infants, serum bilirubin concentrations increase to a level at which irreversible brain damage can occur. The timely diagnosis and management of severe hyperbilirubinemia is essential to prevent acute bilirubin encephalopathy and kernicterus. Kernicterus still occurs although it is almost always preventable. The focus of this guideline is to reduce the incidence of severe hyperbilirubinemia and bilirubin encephalopathy. Therefore, a system-based approach using the recommendations of this guideline should be implemented in all birthing facilities and continued in ambulatory care of the newborn infants.

The aim of this prospective study was to investigate prematurity as a risk factor for developmental dysplasia of the hip (DDH). The hips of 221 infants (88 female, 133 male, mean age 31.11 weeks; standard deviation (sd) 2.51) who were born in the 34th week of gestation or earlier, and those of 246 infants (118 female, 128 male, mean age 40.22 weeks; sd 0.36) who were born in the 40th week of gestation, none of whom had risk factors for DDH, were compared using physical examination and ultrasound according to the technique of Graf, within one week, after the correction of gestational age to the 40th week after birth or one week since birth, respectively. Both hips of all infants were included in the study. Ortolani's and Barlow's tests and restricted abduction were accepted as positive findings on examination. There was a statistically significant difference between pre- and full-term infants, according to the incidence of mature and immature hips (p < 0.001). The difference in the proportion of infants with an α angle < 60° between the two groups was statistically significant (p < 0.001). The incidence of pathological dysplasia (α angle < 50 º) was not significantly different in the two groups (p = 1.000). The Barlow sign was present in two (0.5%) pre-term infants and in 14 (2.8%) full-term infants. These results suggests that prematurity is not a predisposing factor for DDH.

Presepsin can be used as a reliable biomarker for LOS and treatment response in preterm infants. However, we could not demonstrate the efficacy of presepsin for the detection of disease severity or prognosis.

Aim: Neonatal sepsis is an important cause of mortality and morbidity in newborns. The causative agents may be different in different units and may change in time. It was aimed to examine the microbiological agents leading to sepsis, clinical features and antibiotic resistances in babies with sepsis hospitalized in our unit in a two-year period. Material and Methods:The clinical features, microbiological and laboratory results, antibiotic resistance patterns and mortality rates of the newborns with sepsis followed up in our unit between 2010 and 2011 were examined in the patient record system.Results: 351 babies diagnosed with sepsis among 3219 patients hospitalized in the neonatal intensive care unit were included in the study. The mean gestational age was found to be 30.1±4.1 weeks, the mean birth weight was found to be 1417.4±759.1 g and the mean hospitalization time was found to be 43.6±34.4 days. Blood cultures were found to be positive in 167 (47.6%) patients, urine cultures were found to be positive in 6 (7.1%) patients and cerebrospinal fluid cultures were found to be positive in 34 (9.6%) cases. Candida grew in 5 patients (2 patients with early-onset sepsis and 3 patients with late-onset sepsis). The most common cause of sepsis was found to be staphylococci (coagulase negative staphylococcus was found in 65 patients (51%) and Staphylococcus aureus was found in 38 patients (39%). 49.6% (n=63) of the gram positive bacteriae and 60% (n=21) of the gram negative bacteriae were resistant to antibiotics. Six (7.1%) of the patients who were infected with these bacteriae were lost. In total 24 babies were lost because of sepsis. The bacteriae which caused to mortality with the highest rate included E. coli, coagulase negative staphylocicci, S. aureus and Klebsiella. Low birth weight, mechanical ventilation and parenteral nutrition were found to be significant risk factors in terms of mortality. Conclusions:Staphylococci were found to be the most common agents in neonatal sepsis. Low birth weight, mechanical ventilation and parenteral nutrition are significant risk factors in terms of mortality. (Turk Pediatri Ars 2015; 50: 170-5)