Abstract
Very low birth weight infants are at high risk for nosocomial infection specially due to higher survival rates related to advances in intensive care units. Prolonged hospital stay, instrumentalization and immaturity of their immune system are risk factors for infection, being gram-negative bacteria responsible for higher mortality rates and longterm sequelae.
Patients and Methods: Prospective observational study in inborn VLBW infants, describing epidemiological features, morbidity and mortality in relation to risk factors sepsis and type of pathogen isolated in blood cultures. We perfomed flowcytomety analyses in cord blood samples and compared the lymphocyte subpopulations between the group of patients with nosocomial sepsis and the asymptomatic group.
Results: 40 preterm infants were enrolled, mean birth weight (1059± 197 grams) and 29,18±2,05 weeks postmenstrual age. 70% developed late-onset sepsis, with 65% coagulase-negative Stahylococcus, 31% gramnegative bacteria and 4,4% Candida spp. Compared to those without sepsis, patent ductus arteriosus and bronchopulmonary dysplasia was significantly more frequent in the sepsis group (91,7% vs 8,3%; p=0,02; 85,7% vs 14,3%; p=0,064), with longer duration of mechanical ventilation and O2 requirement (3,40 vs 15,04days; p=0,044; 16 vs 46,96 days; p=0,01). CD4+ T lymphocytes were higher in umbilical cord blood in 28 VLBW neotates with sepsis (45,52+/-; 12,13 vs 36,05+/-;10,21; p=0,01) but no differences were observed in CD8+ T cells.
Conclusions: Umbilical cord blood phenotype of immune system differs in VLBW infants with nosocomial infection, with a higher percentage of CD4+ cells. The meaning of this finding and other possible differences remain to be fully interpreted.
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Zamora, E., Luna, S., Maderuelo, E. et al. 1400 Nosocomial Infection and Cd4+ Lymphocytes in Very Low Birth Weight (VLBW) Infants' Cord Blood. Pediatr Res 68 (Suppl 1), 692 (2010). https://doi.org/10.1203/00006450-201011001-01400
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DOI: https://doi.org/10.1203/00006450-201011001-01400