Preterm infants with low immunoglobulin G levels have increased risk of neonatal sepsis but do not benefit from prophylactic immunoglobulin G

Sandberg, Kenneth; Fasth, Anders; Berger, Angelika; Eibl, Martha M.; Isacson, Kristina; Lischka, A; Pollak, Arnold; Tessin, Ingemar; Thiringer, K

doi:10.1067/mpd.2000.109791

Cited by 66 publications

(31 citation statements)

References 15 publications

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“…The mean GA in the three study groups was 30.6± 2 weeks (range, 28-33), 29.9±3 weeks (range, 28-33), and 30.5±2 weeks (range, [28][29][30][31][32][33][34] for neonates with sepsis, those with suspected infection, and control subjects, respectively (p=ns), and the mean BW was 1,655±350, 1,785±377, and 1,733±412 g, respectively (p=ns). Antenatal steroids were given to the mothers of 8 (47%), 12 (48%), and 17 (42.5%) neonates in the three groups, respectively (p=ns).…”

Section: Study Populationmentioning

confidence: 99%

Pre-inflammatory Mediators and Lymphocyte Subpopulations in Preterm Neonates with Sepsis

et al. 2011

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The aim of this study is to investigate prospectively specific immune system factors in preterm neonates with late-onset sepsis and infection-free controls. Matched preterm neonates (n = 82) were divided into three groups: suspected infection (n = 25), sepsis (n = 17), and infection-free controls (n = 40). Serial measurements were made of interleukin-6 (IL-6), IL-1β, tumor necrosis factor-α (TNF-α), lymphocyte subsets [CD3+, CD4+, CD8+, natural killer (NK) cells, and B cells], the immunoglobulins (IgG, IgM, and IgA), C-reactive protein (CRP), and the total blood count, before, 2 days after initiation of treatment, and after stopping treatment. The percentages of NK and B cells were higher in the sepsis group, but those of CD3+, CD4+, and CD8+ showed no differences. IgG was lower in the sepsis group. IL-6 >30 pg/ml and TNF-α >30 pg/ml were sensitive sepsis predictors with sensitivity 1 (0.78-1) and 1 (0.79-1), respectively, but their specificity was poor. CRP was a specific [0.90 (0.80-0.96)] but not sensitive index [0.68 (0.48-0.85)], and its combination with IL-6 or TNF-α could enhance their diagnostic accuracy. It is concluded that NK and B cells may be elevated in late neonatal sepsis. IL-6 or TNF-α combined with CRP is a good diagnostic marker for late-onset sepsis in preterm neonates.

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Section: Study Populationmentioning

confidence: 99%

Pre-inflammatory Mediators and Lymphocyte Subpopulations in Preterm Neonates with Sepsis

et al. 2011

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“…In addition, there are immunologic reasons why infection occurs. The absence of passively derived maternal antibody such as that directed against Group B Streptococcus appears to be important (4,5). Indeed premature neonates of less than 32 wk of gestation have fetal IgG concentrations of less than 50% of maternal levels (6,7).…”

Section: Espite Advances In Perinatal Care Neonatal Infection Re-mentioning

confidence: 99%

The Role of Mannose-Binding Lectin in Susceptibility to Infection in Preterm Neonates

et al. 2008

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Preterm neonates are susceptible to infection due to a combination of sub-optimal immunity and increased exposure to invasive organisms. Mannose-binding lectin (MBL) is a component of the innate immune system, which may be especially important in the neonatal setting. The objective of this study was to investigate the impact of MBL on susceptibility and severity of infection in preterm neonates during their first month of life. One hundred fifty eight preterm neonates were genotyped for MBL mutations by heteroduplex analyses. Consecutive serum MBL levels were measured by ELISA and clinical and laboratory data, including blood cultures, were collected for each baby. A third of the premature neonates had genetically determined MBL deficiency. In addition, MBL levels were also low in the first week of life and lower in neonates with a wild type genotype who were less than 28 wk gestation or a birth weight of less than 1000 g, thereby increasing the number of neonates with a low MBL level at birth. MBL deficiency was associated with an increased risk of sepsis (p Ͻ 0.01). This study indicates that MBL levels are low in neonates at birth and renders premature neonates to an increased risk of infection. (Pediatr Res 63: 680-685, 2008)

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“…6,7 The absence of passively derived maternal antibodies, low or suboptimal functioning of acquired immune system and decreased function of neutrophils may be responsible for the host-defense impairment in both term and preterm infants, so newborns might have increased susceptibility to infections. 8,9 Therefore, it may be suggested that innate immune system might provide protection against infections in postnatal period. In recent years, limited number of studies evaluated the effect of defects in the innate immune system, especially the role of MBL levels contributing to predisposition to neonatal sepsis.…”

Section: Introductionmentioning

confidence: 99%

Serum mannose-binding lectin (MBL) gene polymorphism and low MBL levels are associated with neonatal sepsis and pneumonia

et al. 2011

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Objective: The aim of this study was to determine the serum mannosebinding lectin (MBL) levels and the frequency of MBL gene polymorphisms in infants with neonatal sepsis.Study Design: Between January 2008 and January 2010, a total of 93 infants were included in this study and 53 of them had neonatal sepsis diagnosis as study group and 40 infants who had no sepsis according to clinical and laboratory findings as control group.Result: Serum MBL levels were found to be low in 17 of 93 infants. Eleven of them were in the sepsis group and six of them were in the control group. Serum MBL levels were significantly lower in infants with sepsis compared with the control group. Frequencies of genotype AB and BB were also significantly higher in the study group compared with the control group. Most importantly, presence of B allele of MBL exon 1 gene was found to be associated with an increased risk for neonatal sepsis. Additionally, in the study group, the mean serum MBL levels were found to be significantly lower in the premature infants compared with the term infants. Pneumonia, bronchopulmonary dysplasia (BPD) and intraventricular hemorrhage (IVH) were significantly higher in infants with MBL deficiency compared with infants with normal MBL levels.Conclusion: Low MBL levels and presence of B allele of MBL exon 1 gene were found to be important risk factors for development of both neonatal sepsis and pneumonia, especially in premature infants. Low MBL levels and MBL gene polymorphisms might also be associated with inflammation-related neonatal morbidities such as BPD and IVH.

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Preterm infants with low immunoglobulin G levels have increased risk of neonatal sepsis but do not benefit from prophylactic immunoglobulin G

Cited by 66 publications

References 15 publications

Pre-inflammatory Mediators and Lymphocyte Subpopulations in Preterm Neonates with Sepsis

Pre-inflammatory Mediators and Lymphocyte Subpopulations in Preterm Neonates with Sepsis

The Role of Mannose-Binding Lectin in Susceptibility to Infection in Preterm Neonates

Serum mannose-binding lectin (MBL) gene polymorphism and low MBL levels are associated with neonatal sepsis and pneumonia

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