Infection control and other stewardship strategies in late onset sepsis, necrotizing enterocolitis, and localized infection in the neonatal intensive care unit

Aleem, Samia; Wohlfarth, Megan; Cotten, C. Michael; Greenberg, Rachel G.

doi:10.1016/j.semperi.2020.151326

Cited by 7 publications

(5 citation statements)

References 159 publications

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“…The pathogenesis is that the bacteria and infected foci caused by the infection in the patient have an adverse effect on the balance of local blood circulation, which makes the microcirculation function of relevant tissues disordered in the process of disease, thus affecting the patient's heart and other organs. This will lead to myocardial cell damage and insufficient heart filling, imbalance of oxygen supply, and demand in tissues and organs [ 10 , 11 ]. In recent years, medical institutions have carried out a large number of clinical studies on the treatment of sepsis.…”

Section: Related Workmentioning

confidence: 99%

[Retracted] Analysis of the Predictive Effect of Lactic Acid Combined with Cardiac Troponin T and 5‐Hydroxytryptophan on the Severity of Sepsis in ICU Patients and Its Correlation with Prognosis

Jiang

Wang

et al. 2022

Contrast Media & Molecular Imaging

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In order to explore the effective markers of presepsis in the prediction of clinical disease and disease severity, the predictive effect of lactic acid (Lac) combined with cardiac troponin T (cTnT) and 5-hydroxytryptophan (5-HT) on the severity of sepsis in intensive care unit (ICU) patients and its correlation with prognosis is investigated. A total of 85 sepsis patients admitted to the ICU of our hospital from January 2020 to June 2021 are selected to establish the ICU sepsis group, and 72 health examination patients who received physical examination in our hospital during the same period are included in the healthy control group. The experimental results demonstrate that combined detection mode of serum Lac, cTnT, and 5-HT indicators has a high predictive value for the condition of patients with ICU sepsis and those indicators are closely correlated with the prognosis of patients. It suggests that the follow-up clinical monitoring of serum Lac, cTnT, and 5-HT indicators for patients with ICU sepsis can evaluate their condition and improve and optimize the clinical diagnosis and treatment plan effectively.

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Section: Related Workmentioning

confidence: 99%

[Retracted] Analysis of the Predictive Effect of Lactic Acid Combined with Cardiac Troponin T and 5‐Hydroxytryptophan on the Severity of Sepsis in ICU Patients and Its Correlation with Prognosis

Jiang

Wang

et al. 2022

Contrast Media & Molecular Imaging

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“…Lung ultrasound score and oxygenation index were consistent in guiding the selection of optimal PEEP. Lung ultrasound scores can be used to monitor the effect of lung recruitment and select the best PEEP [ 11 ].…”

Section: Literature Reviewmentioning

confidence: 99%

[Retracted] Clinical Value and Imaging Features of Bedside High‐Frequency Ultrasound Imaging in the Diagnosis of Neonatal Pneumonia

Zhu¹,

Chen²,

Jiang³

2022

Contrast Media & Molecular Imaging

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The aim is to solve the problem of the urgent need of a nonradiation, noninvasive, and simple-to-operate diagnostic method for neonatal pneumonia that can indicate the severity of the disease and dynamically monitor the outcome of the disease. The authors propose a bedside high-frequency ultrasound technique based on methods for evaluation in the detection and treatment of neonatal pneumonia. The results obtained are as follows: the sensitivity of neonatal lung ultrasound in the diagnosis of neonatal pneumonia was 96.6%, the specificity was 93.3%, the positive predictive value was 93.5%, and the negative predictive value was 96.5%. The sensitivity of chest X-ray in the diagnosis of neonatal pneumonia was 93.3%. Compared with the lung ultrasound and chest X-ray in the diagnosis of neonatal pneumonia, the two had a good correlation. The neonatal respiratory score was positively correlated with the lung ultrasound score, and the higher the lung ultrasound score, the more severe the disease. The score decreased by 35% after 3 days of treatment and 68% after 7 days of treatment, indicating that the lung high-frequency ultrasound score can be very effective in characterizing the treatment situation. It has been demonstrated that the lung ultrasound can be used as an imaging method for the diagnosis of neonatal pneumonia. The higher the lung ultrasound score, the more severe the disease, and the lung ultrasound score was positively correlated with the disease severity. With dynamic monitoring of the lung ultrasound and the gradual improvement of clinical symptoms after treatment, the lung ultrasound score gradually decreased; therefore, the lung ultrasound can be used for re-examination of neonatal pneumonia to evaluate the treatment effect and guidance.

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“… 16 17 Currently, ampicillin, gentamycin, and metronidazole are widely used abroad, while carbapenems, penicillin and cephalosporins, and nitroimidazole are the most used antibiotics in China. 17 18 There is no consensus on the best combination of antibiotics. 19 Aminoglycosides are not commonly used in China due to ototoxicity and nephrotoxicity.…”

Section: Discussionmentioning

confidence: 99%

Survey on surgical treatment of neonatal necrotizing enterocolitis in China 2022

Gao

Lai

Tou

2023

World Jnl Ped Surgery

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ObjectiveThe aim of this study was to identify the state of surgical treatment of neonatal necrotizing enterocolitis (NEC) in China.MethodsA total of 246 delegates (88.0% senior surgeons) completed a survey sent by the Neonatal Surgery Group of the Pediatric Surgery Branch of the Chinese Medical Association in 2022. Five centers were eliminated due to lack of experience.ResultsGenerally, 38.2% of surgeons work in centers where more than 20 cases of surgical NEC are treated per year. A total of 81.3% of surgeons reported the use of ultrasonography; the most used biomarkers were white blood cell count (95.9%), C-reactive protein (93.8%), and procalcitonin (76.3%). Most surgeons (80.9%) used a combination of two (67.2%) antibiotics or single (29.5%) antibiotic for a treatment period of 7–14 days, and most used antibiotics were carbapenems (73.9%), penicillin and cephalosporins (56.0%). Patients are issued the fasting order for 5–7 days by nearly half surgeons (49.8%) for conservative treatment. 70.1% of surgeons deemed that the most difficult decision was to evaluate the optimal timing of surgery. Most surgeons (76.3%) performed diagnostic aspiration of peritoneal fluid. Laparoscopy was performed for the diagnosis and/or treatment of NEC by 40.2% of surgeons. A total of 53.5% of surgeons reported being able to identify localized intestinal necrosis preoperatively. Surgeons relied the most on pneumoperitoneum (94.2%) and failure of conservative treatment (88.8%) to evaluate the surgical indications. At laparotomy, surgical treatments vary according to NEC severity. Infants are fasted for 5–7 days by 55.2% of surgeons postoperatively. Most surgeons (91.7%) followed up with patients with NEC after discharge for up to 5 years (53.8%).ConclusionsThe most difficult aspect of surgical NEC is evaluating the timing of surgery, and surgeons in the children’s specialized hospitals are experienced. The treatment of NEC totalis is controversial, and the indications for laparoscopy need to be further clarified. More multicenter prospective studies are needed to develop surgical guidelines in the future.

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Infection control and other stewardship strategies in late onset sepsis, necrotizing enterocolitis, and localized infection in the neonatal intensive care unit

Cited by 7 publications

References 159 publications

[Retracted] Analysis of the Predictive Effect of Lactic Acid Combined with Cardiac Troponin T and 5‐Hydroxytryptophan on the Severity of Sepsis in ICU Patients and Its Correlation with Prognosis

[Retracted] Analysis of the Predictive Effect of Lactic Acid Combined with Cardiac Troponin T and 5‐Hydroxytryptophan on the Severity of Sepsis in ICU Patients and Its Correlation with Prognosis

[Retracted] Clinical Value and Imaging Features of Bedside High‐Frequency Ultrasound Imaging in the Diagnosis of Neonatal Pneumonia

Survey on surgical treatment of neonatal necrotizing enterocolitis in China 2022

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