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PP-138. Viral infections in a neonatal intensive care unit
Abstracts
PP-138. Viral infections in a neonatal intensive care unit Sofia Aguedaa, Andreia Leitaoa, Gustavo Rochaa, Hercilia Guimaraesb Neonatal Intensive Care Unit, Hospital São João, University of Porto, Portugal b Faculty of Medicine, University of Porto, Portugal
S73
phase prognosis (assessed by whether lethal state or not within 72 h from onset of infection) in newborns with K. pneumoniae sepsis.
a
Aim The incidence of neonatal viral infections is probably underestimated because viral studies are not routinely obtained in neonates. Our objective was to determine the incidence of viral infections among hospitalized infants in a level III neonatal intensive care unit (NICU), the associated clinical manifestations and outcome. Case presentation We conducted an observational retrospective study of patients admitted to the NICU over a ten year period (2000–2009), with analysis of the data of patients with laboratory confirmed viral infection. Conclusion A viral infection was diagnosed in 1.7% of infants admitted to the NICU: 33.3% respiratory syncytial virus (RSV), 18.2% metapneumovirus, 16.7% influenza H1N1 and 13.6% cytomegalovirus (CMV). Other virus found were rotavirus, adenovirus, enterovirus, parainfluenza, herpes simplex and varicella zoster. The medium length of stay (MLS) was 30 days and most infants were not inborn. In the inborn infants the more common virus was H1N1, CMV and metapneumovirus. 48.5% of these infections occurred in preterm. The CMV cases were generally symptomatic infections treated with ganciclovir with favorable outcome. The VSR cases had a good evolution, short MLS, 45.5% required invasive ventilation (IV) and 81.8% began bronchodilator therapy. The metapneumovirus and parainfluenza cases had a favorable evolution, but needed IV more frequently. The adenovirus infections all needed IV and had longer MLS. During the year 2009 there was an outbreak of H1N1 infection which required specific isolation measures. All these patients received oseltamivir and the evolution was very favorable. These infants were all asymptomatic. The enterovirus infections occurred during another outbreak in 2007 and presented with sepsis like disease, with 100% mortality. The rotavirus cases presented with diarrhea or abdominal distention. The overall mortality was 4.5%. In our study the respiratory infections were the most common viral infections and the overall mortality was low. It's our job to prevent these infections and to make easier their early identification and treatment. doi:10.1016/j.earlhumdev.2010.09.192
PP-139. Risk factors for acute phase prognosis of Klebsiella pneumoniae sepsis in neonatal intensive care unit patients Chun Soo Kima, Dae Hoon Kimb, Sang Lak Leea Keimyung University School of Medicine, South Korea b I Dream Place Children's Hospital, South Korea
Materials and methods Retrospective case–control study was conducted on patients who were admitted in a NICU over an 8.5-year period (Jan 2001–Jun 2009). Results During study period, there were 33 cases of K. pneumoniae sepsis and acute death developed in eight (24.2%) of them. The 8 infants (death group) and the 25 infants (survival group) were similar in comparison of the perinatal parameters such as gestational age, birth weight and antenatal steroid therapy. Most patients with K. pneumoniae sepsis had risk factors of nosocomial infection such as prematurity, feeding intolerance, antibiotic therapy, parenteral nutrition and central catheterization, but there were no different significances between two groups. Logistic regression analysis showed that the significant independent factor associated with acute death was severe infection at onset of bacteremia (OR: 14.1, 95% CI: 1.5–134.9). Conclusions Severe infection at onset of bacteremia may be a definite risk factor associated with acute mortality in NICU patients with K. pneumoniae sepsis. Thus additional studies are necessary to make interventions for preventing severe sepsis with improving infection control measures. doi:10.1016/j.earlhumdev.2010.09.193
PP-140. Congenital diaphragmatic eventration secondary to intrauterine Parvo B19 infection Georgios Mitsiakosa, Christoforos Gavrasa, Evangelia Giougia, Ioannis Efstratioub, Apostolos Athanasianidisc, Theodoros Theodoridisc, Basil Tarlatzisc, Nikolaos Nikolaidisa a B' NICU, Aristotle University of Thessaloniki, “Papageorgiou” Hospital, Greece b Department of Pathology, “Papageorgiou” Hospital, Greece c First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, “Papageorgiou” Hospital, Greece Aim Fetal malformations secondary to Parvo B19 infection have occasionally been reported, although the teratogenicity of the virus has not been fully investigated. The fetus is more vulnerable during the second trimester when hemopoiesis is performed mainly in the liver and red blood cells have a short half life. Parvo B19 virus appears to have an affinity for fetal muscle cells, probably all types, as can be concluded from the findings in the heart, skeletal muscle and umbilical artery tissue samples.
a
Aim Klebsiella pneumoniae sepsis is a major cause of morbidity and mortality in neonatal intensive care unit (NICU) patients. This study was undertaken to find significant risk factors associated with acute
Case presentation A preterm (GA: 32 weeks) female neonate weighing 2060 g was born with cardiac malformations (PDA, ASD with right-to-left shunt and marked pulmonary hypertension), ascites, hydrothorax and congenital right-sided diaphragmatic hernia (CDH); defects had already been diagnosed by ultrasonography since the 20th week of gestation while
PP-138. Viral infections in a neonatal intensive care unit Sofia Aguedaa, Andreia Leitaoa, Gustavo Rochaa, Hercilia Guimaraesb Neonatal Intensive Care Unit, Hospital São João, University of Porto, Portugal b Faculty of Medicine, University of Porto, Portugal
S73
phase prognosis (assessed by whether lethal state or not within 72 h from onset of infection) in newborns with K. pneumoniae sepsis.
a
Aim The incidence of neonatal viral infections is probably underestimated because viral studies are not routinely obtained in neonates. Our objective was to determine the incidence of viral infections among hospitalized infants in a level III neonatal intensive care unit (NICU), the associated clinical manifestations and outcome. Case presentation We conducted an observational retrospective study of patients admitted to the NICU over a ten year period (2000–2009), with analysis of the data of patients with laboratory confirmed viral infection. Conclusion A viral infection was diagnosed in 1.7% of infants admitted to the NICU: 33.3% respiratory syncytial virus (RSV), 18.2% metapneumovirus, 16.7% influenza H1N1 and 13.6% cytomegalovirus (CMV). Other virus found were rotavirus, adenovirus, enterovirus, parainfluenza, herpes simplex and varicella zoster. The medium length of stay (MLS) was 30 days and most infants were not inborn. In the inborn infants the more common virus was H1N1, CMV and metapneumovirus. 48.5% of these infections occurred in preterm. The CMV cases were generally symptomatic infections treated with ganciclovir with favorable outcome. The VSR cases had a good evolution, short MLS, 45.5% required invasive ventilation (IV) and 81.8% began bronchodilator therapy. The metapneumovirus and parainfluenza cases had a favorable evolution, but needed IV more frequently. The adenovirus infections all needed IV and had longer MLS. During the year 2009 there was an outbreak of H1N1 infection which required specific isolation measures. All these patients received oseltamivir and the evolution was very favorable. These infants were all asymptomatic. The enterovirus infections occurred during another outbreak in 2007 and presented with sepsis like disease, with 100% mortality. The rotavirus cases presented with diarrhea or abdominal distention. The overall mortality was 4.5%. In our study the respiratory infections were the most common viral infections and the overall mortality was low. It's our job to prevent these infections and to make easier their early identification and treatment. doi:10.1016/j.earlhumdev.2010.09.192
PP-139. Risk factors for acute phase prognosis of Klebsiella pneumoniae sepsis in neonatal intensive care unit patients Chun Soo Kima, Dae Hoon Kimb, Sang Lak Leea Keimyung University School of Medicine, South Korea b I Dream Place Children's Hospital, South Korea
Materials and methods Retrospective case–control study was conducted on patients who were admitted in a NICU over an 8.5-year period (Jan 2001–Jun 2009). Results During study period, there were 33 cases of K. pneumoniae sepsis and acute death developed in eight (24.2%) of them. The 8 infants (death group) and the 25 infants (survival group) were similar in comparison of the perinatal parameters such as gestational age, birth weight and antenatal steroid therapy. Most patients with K. pneumoniae sepsis had risk factors of nosocomial infection such as prematurity, feeding intolerance, antibiotic therapy, parenteral nutrition and central catheterization, but there were no different significances between two groups. Logistic regression analysis showed that the significant independent factor associated with acute death was severe infection at onset of bacteremia (OR: 14.1, 95% CI: 1.5–134.9). Conclusions Severe infection at onset of bacteremia may be a definite risk factor associated with acute mortality in NICU patients with K. pneumoniae sepsis. Thus additional studies are necessary to make interventions for preventing severe sepsis with improving infection control measures. doi:10.1016/j.earlhumdev.2010.09.193
PP-140. Congenital diaphragmatic eventration secondary to intrauterine Parvo B19 infection Georgios Mitsiakosa, Christoforos Gavrasa, Evangelia Giougia, Ioannis Efstratioub, Apostolos Athanasianidisc, Theodoros Theodoridisc, Basil Tarlatzisc, Nikolaos Nikolaidisa a B' NICU, Aristotle University of Thessaloniki, “Papageorgiou” Hospital, Greece b Department of Pathology, “Papageorgiou” Hospital, Greece c First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, “Papageorgiou” Hospital, Greece Aim Fetal malformations secondary to Parvo B19 infection have occasionally been reported, although the teratogenicity of the virus has not been fully investigated. The fetus is more vulnerable during the second trimester when hemopoiesis is performed mainly in the liver and red blood cells have a short half life. Parvo B19 virus appears to have an affinity for fetal muscle cells, probably all types, as can be concluded from the findings in the heart, skeletal muscle and umbilical artery tissue samples.
a
Aim Klebsiella pneumoniae sepsis is a major cause of morbidity and mortality in neonatal intensive care unit (NICU) patients. This study was undertaken to find significant risk factors associated with acute
Case presentation A preterm (GA: 32 weeks) female neonate weighing 2060 g was born with cardiac malformations (PDA, ASD with right-to-left shunt and marked pulmonary hypertension), ascites, hydrothorax and congenital right-sided diaphragmatic hernia (CDH); defects had already been diagnosed by ultrasonography since the 20th week of gestation while