Chryseobacterium indologenes is an uncommon organism that has been documented to cause a variety of invasive infections mostly in hospitalized patients with severe underlying diseases. A three-month-old female infant born at term by caesarean section with meningomyelocele and congenital diaphragmatic hernia had two surgeries for the repair of meningomyelocele and diaphragmatic hernia on her 3rd and 14th day, respectively. On the 3rd month of her life, she deteriorated clinically with fever, leukocytosis and increase of acute-phase reactants. Gas exchange condition became worse than it was before. Respiratory secretions, oxygen requirements and ventilator demand increased. Chest X-ray showed bilateral pulmonary infiltrates. Bacteriological blood, urine and cerebrospinal fluid culture test results were negative. C. indologenes was isolated from tracheobronchial secretion sample obtained by endotracheal aspiration. Although susceptible to ciprofloxacin (MIC:0.5 gr/L), levofloxacin and piperacillin–tazobactam, the isolate was resistant to meropenem, imipenem and colistin. She was treated with ciprofloxacin successfully. Her fever resolved and gas exchange condition improved after 72 h of the treatment. The antibiotic treatment was given for a course of 14 days. Chryseobacterium indologenes may emerge as a potential pathogen in infants with the factors such as invasive equipment, having underlying diseases and prolonged hospitalization.
Advances in diagnostic and therapeutic methods have led to a paradigm shift in the management of bronchopulmonary dysplasia (BPD). The lack of evidence-based data in this area has led to variations in clinical practice. The aim of this study was to identify these differences and compare them with recommendations based on pathophysiology. The study was designed as an observational online survey of neonatologists from level 3 to 4 neonatal intensive care units caring for premature infants at increased risk of BPD and born before 28 weeks’ gestation. Respondents were invited to participate in the study through the portal of the Turkish Neonatal Society. Participants were surveyed online about preferred ventilation modes, settings and clinical management of these patients through each respiratory distress syndrome, evolving BPD and severe BPD phases. A total of 39 centers involved in the study. Pressure-control assist-control volume-guaranteed was the most commonly preferred ventilation mode in respiratory distress syndrome and evolving BPD, while high frequency oscillatory ventilation was most commonly used in severe BPD. The use of synchronized intermittent mandatory ventilation volume-guaranteed pressure support ventilation increased with disease progression. Ventilation settings were found to be changed according to pathophysiological recommendations, but not to the extent recommended. The study shows that early ventilation strategies are predominantly maintained in the later phases of BPD, although there are notable differences between centers.
Retinopathy of prematurity (ROP) is a preventable cause of childhood blindness in extremely preterm infants, yet early biomarkers are lacking. In this pilot study, we utilized targeted metabolomic profiling of blood samples to measure plasma 6-hydroxymethylpterin (6PTC) levels in 18 preterm neonates. Results showed significantly higher 6PTC levels in infants who developed ROP compared to those who did not (p = 0.035), with receiver-operating characteristic analysis yielding an AUC of 0.831. These findings suggest that 6PTC may serve as a non-invasive early biomarker reflecting oxidative stress in ROP. However, the modest sample size warrants further validation in larger, longitudinal cohorts. Given the limited sample size, these results should be interpreted within the context of a pilot, hypothesis-generating study.
1 January 2014 in International Journal of Clinical Pediatrics
The aim of this study was to evaluate tubular functions of posterior urethral valve patients with preserved glomerular functions.A total of 25 children (ages 1 - 18) who underwent surgery for PUV and had an estimated glomerular filtration rate ≥ 90 mL/min per 1.73 m2 on long term follow-up and age-matched 25 healthy controls were enrolled. Blood and urine samples were collected to assess electrolyte reabsorption, proteinuria, enzymuria, urine acidification and concentration.Even though microalbumin/creatinine ratio was higher in the patient group [1.00 (1.98) vs 0.31 (0.34) mg/gr creatinine, P = 0.005] none of the subjects had enzymuria, overt proteinuria or hyperphosphaturia. Serum bicarbonate levels were lower and urinary pH higher in patients than the controls (23.2 ± 2.1 vs. 24.6 ± 1.9 mmol/L, P = 0.028 and 6.24 ± 0.77 vs. 5.60 ± 0.64, P = 0.004); furthermore, patients had lower urinary osmolality and density (525 ± 214 vs. 743 ± 194 mOsm/L, P = 0.001 and 1011 ± 5.0 vs. 1016 ± 6.8, P = 0.005). When patients were compared among themselves according to presence or absence of renal scarring and when patients without renal scars were compared to healthy controls, similar findings persisted.This study showed that during long-term follow-up of posterior urethral valve patients with normal glomerular filtration rates, even though proximal tubular functions do not seem to be impaired, acidification and concentration defects exist indicating distal tubulopathy.