• Neonatal Medicine
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• 제16권2호
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• pp.190-196
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• 2009

목 적 : 신생아 집중치료실에서 극소 저체중 출생아의 칸디다 감염이 증가하고 있다. 그러나 우리나라에서 미숙아의 전신성 칸디다 감염에 대한 최근 자료는 부족하다. 본 연구는 최근 5년 간 극소 저체중 출생아에서 발생한 전신성 칸디다 감염의 역학적 양상에 대해 알아보고자 한다. 방 법 : 2004년 1월 1일부터 2008년 12월 31일까지 가톨릭의과대학교 부속 3개 병원 신생아 집중치료실에 입원한 극소 저체중 출생아 중 전신성 칸디다 감염이 발생한 환자 19명의 의무기록지를 후향적으로 검토하여 출생 체중, 재태기간, 진단시 나이, 위험 인자, 동반 질환, 항진균제 치료, 사망 등을 분석하였다. 결 과 : 19명(4.7%)의 극소 저체중 출생아에서 전신성 칸디다 감염이 진단되었다. 출생 체중은 평균 959.0$\pm$255.9 g이었고 재태기간은 26.7$\pm$2.1주였다. 동정된 균종은 C. albicans (4례), C. parapsilosis (9례), C. glabrata (2례), C. famata (2례)였고 아종을 분류하지 못한 경우가 2건 있었다. 위험 인자인 중심 정맥 카테터 사용, 항생제 정맥 영양과 지방 유제 투어, 기도 삽관, $H_2$ blocker 사용은 대부분의 환자에서 연관이 있었다. 칸디다 감염 환자 중 사망한 경우와 생존한 경우 간에 재태기간을 제외한 차이는 없었다. 19명의 감염자 중 9명(47.4%)이 사망하였고 칸디다 관련 사망은 4건(21.1%)이 있었다. 결 론 : 극소 저체중 출생아에서 전신성 칸디다 감염의 발생 빈도가 꾸준히 증가하고 있으며 이전에 비해 C. non-albicans 특히 C. parapsilosis로 인한 감염이 빈번했다. 신생아 중환자실에서 칸디다 감염은 사망률이 매우 높기 때문에 역학적 자료에 근거한 예방 요법 및 조기 치료가 필요할 것으로 생각된다.

• Clinical and Experimental Pediatrics
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• 제56권8호
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• pp.332-337
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• 2013

Purpose: To identify the frequency of bacterial isolates in early-onset neonatal sepsis (EONS) and their antimicrobial resistance pattern. Methods: A retrospective study of EONS was conducted at the Beni Suef University Hospital from September 2008 to September 2012. A case of EONS was defined as an infant who had clinical signs of infection or who was born to a mother with risk factors for infection, and in whom blood culture obtained within 72 hours of life grew a bacterial pathogen. Results: Of 673 neonates screened, there were 138 positive blood cultures (20.5%) (confirmed EONS). Of the recovered isolates, 86.2% were gram-negative pathogens. Klebsiella pneumoniae (42.8%), Enterobacter cloacae (22.5%), and Escherichia coli (13.8%) were the commonest isolated organisms. The most common gram-positive microorganism was Staphylococcus aureus accounting for only 12 isolates (8.7%). All Klebsiella isolates and 93% of Enterobacter isolates were resistant to ampicillin. Gram-negative pathogens had the maximum overall sensitivity to imipenem, cefepime, and ciprofloxacin; whereas, gram-positive isolates were most susceptible to vancomycin, imipenem, and piperacillin. Conclusion: K. pneumoniae was the predominant causative bacteria of EONS followed by E. cloacae and E. coli. There was a high resistance to ampicillin. Imipenem had the maximum overall activity against the causative bacteria. Continuous surveillance is needed to monitor the changing epidemiology of pathogens and antibiotic sensitivity.

• Clinical and Experimental Pediatrics
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• 제65권4호
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• pp.182-187
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• 2022

We frequently encounter newborn infants with thrombocytosis in the neonatal intensive care unit. However, neonatal thrombocytosis is not yet fully understood. Thrombocytosis is more frequently identified in newborns and young infants, notably more often in those younger than 2 years than in older children or adults. The production of megakaryocytes (megakaryopoiesis) and platelets (thrombopoiesis) is mainly regulated by thrombopoietin (TPO). Increased TPO levels during infection or inflammation can stimulate megakaryopoiesis, resulting in thrombopoiesis. TPO concentrations are higher in newborn infants than in adults. Levels increase after birth, peak on the second day after birth, and start decreasing at 1 month of age. Initial platelet counts at birth increase with gestational age. Thus, preterm infants have lower initial platelet counts at birth than late-preterm or term infants. Postnatal thrombocytosis is more frequently observed in preterm infants than in term infants. A high TPO concentration and low TPO receptor expression on platelets leading to elevated plasma-free TPO, increased sensitivity of megakaryocyte precursor cells to TPO, a decreased red blood cell count, and immaturity of platelet regulation are speculated to induce thrombocytosis in preterm infants. Thrombocytosis in newborn infants is considered a reactive process (secondary thrombocytosis) following infection, acute/chronic inflammation, or anemia. Thrombocytosis in newborn infants is benign, resolves spontaneously, and, unlike in adults, is rarely associated with hemorrhagic and thromboembolic complications.

• Pediatric Infection and Vaccine
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• 제21권3호
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• pp.219-224
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• 2014

Streptococcus bovis에 의한 신생아 침습감염을 보고한 사례는 많지 않으며, 지금까지 보고된 증례는 대부분 Streptococcus pasteurianus가 원인이었다. 저자들은 생후 28일에 열이 나서 온 환자의 혈액과 뇌척수액에서 분리된 균주를 16S rRNA와 tuf 유전자 염기서열분석을 통해 Streptococcus lutetiensis로 동정할 수 있었다. 환자의 혈액에서 배양된 균주는 자동화 장비(VITEK 2)에서 Streptococcus infantarius로 동정되었고 뇌척수액에서 자란 균주는 동정되지 않았다. 환자는 항균제 투여 2일째부터 열이 떨어지고 전신상태가 호전되었으며, 14일간 항균제 사용 후 신경학적 합병증 없이 퇴원하였다. 저자들은 S. bovis군에 의한 침습 감염 환자에서 정확한 균주 동정을 위해 분자유전학적 검사기법이 도움이 될 수 있음을 확인하였고 본 증례의 원인 균주가 신생아 침습감염의 원인으로 알려진 사례가 없어 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제55권8호
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• pp.272-279
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• 2012

Purpose: The aim of this study was to develop an appropriate nursing information guideline according to corrected age, after investigating parents' concerns about the growth, development, and diseases of their premature infants after discharge from the neonatal intensive care unit (NICU). Methods: The parents of premature infants (birth weight, <2,500 g; gestational age, <37 weeks) who went to a neonatal follow-up clinic after NICU discharge at Seoul St. Mary's Hospital from January 2005 to December 2009, were asked with regard to their concerns about their infants through a questionnaire survey. The results of physical examinations, including body measurements and neurodevelopmental status at 4, 8, 12, and 18 months of corrected age, were retrospectively reviewed in 390 infants. Results: The most common parental concerns were developmental delay, poor growth, and feeding and nutritional problems. Parental concerns about developmental delay, growth failure in improvement in body weight and length, and overweightness were high in specificity but very low in sensitivity. After NICU discharge, 30% of premature infants experienced infectious diseases before 18 months of corrected age, the most common of which was respiratory tract infection. Conclusion: For guiding of premature infants in outpatient day clinics after NICU discharge, it is necessary to identify the parents' highest concerns, to educate them about the possibilities of growth and neurodevelopmental disabilities in their infants and to provide them with handouts containing guidelines on the management of infectious diseases, especially respiratory infections.

• Clinical and Experimental Pediatrics
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• 제64권5호
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• pp.239-246
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• 2021

Background: The consequences of severe acute respiratory syndrome corona virus 2 on mother and fetus remain unknown due to a lack of robust evidence from prospective studies. Purpose: This study evaluated the effect of coronavirus disease 2019 (COVID-19) on neonatal outcomes and the scope of vertical transmission. Methods: This ambispective observational study enrolled pregnant women with COVID-19 in North India from April 1 to August 31, 2020 to evaluate neonatal outcomes and the risk of vertical transmission. Results: A total of 44 neonates born to 41 COVID-19-positive mothers were evaluated. Among them, 28 patients (68.3%) (2 sets of twins) were delivered within 7 days of testing positive for COVID-19, 23 patients (56%) (2 sets of twins) were delivered by cesarean section; 13 newborns (29.5%) had low birth weight; 7 (15.9%) were preterm; and 6 (13.6%) required neonatal intensive care unit admission, reflecting an increased incidence of cesarean delivery and low birth weight but zero neonatal mortality. Samples of cord blood, placental membrane, vaginal fluid, amniotic fluid, peritoneal fluid (in case of cesarean section), and breast milk for COVID-19 reverse transcription-polymerase chain reaction tested negative in 22 prospective delivery cases. Nasopharyngeal swabs of 2 newborns tested positive for COVID-19: one at 24 hours and the other on day 4 of life. In the former case, biological samples were not collected as the mother was asymptomatic and her COVID-19 report was available postdelivery; hence, the source of infection remained inconclusive. In the latter case, all samples tested negative, ruling out the possibility of vertical transmission. All neonates remained asymptomatic on follow-up. Conclusion: COVID-19 does not have direct adverse effects on the fetus per se. The possibility of vertical transmission is almost negligible, although results from larger trials are required to confirm our findings.

• 한국수의병리학회:학술대회논문집
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• 한국수의병리학회 2000년도 추계학술대회 및 정기총회
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• pp.25-25
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• 2000

N. caninum infections have been associated with neonatal paresis as well as abortion around the world. Bovine abortion induced by N. caninum was first reported in 1997 in Korea. Diagnosis of N. caninum infection is usually based on histopathology and immunohistochemical detection of organism. However, often the tissues having lesion suggestive of N. caninum infection were negative on immunohistochemistry. (omitted)

• Pediatric Infection and Vaccine
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• 제24권1호
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• pp.1-6
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• 2017

목적: 본 연구에서는 delta neutrophil index (DNI)가 신생아 균혈증을 예측하는 지표로서의 효용성을 다른 지표들과의 비교를 통해 알아보고자 하였다. 방법: 원주세브란스 기독병원 신생아 중환자실에 발열을 주소로 입원한 환아들과 입원 중 발열이 있었던 생후 31일 미만 환아 146명을 대상으로 혈액배양검사와 동시에 시행한 총 백혈구 수, 절대호중구수, DNI, 혈소판 수, C-반응단백(C-reactive protein, CRP)에 대하여 분석하였다. 결과: 균혈증이 있었던 환아 77명의 평균 재태주수는 38.74주, 출생 체중은 3.20 kg였다. 대조군의 평균 재태주수는 33.34주, 출생 체중은 2.20 kg였다. 균혈증의 원인은 Staphylococcus aureus (22명), Staphylococcus epidermidis (18명), Streptococcus agalactiae (8명) 등이었다. DNI와 CRP만이 재태주수와 출생 체중 보정 후 균혈증과 연관성을 보여 area under the ROC curve를 조사하였고 DNI 0.70, CRP 0.68이었다. 결론: DNI는 신생아 균혈증을 예측하는 데 효과적인 지표이다. 다른 인자들과 함께 고려한다면 균혈증을 예측하는 데 더 도움이 될 것이다.

• Clinical and Experimental Pediatrics
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• 제61권9호
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• pp.265-270
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• 2018

Neonates, especially extremely low birth weight infants, are among the groups of patients undergoing transfusion frequently. Since they are exposed to higher specific transfusion risks compared to the patients of other age groups, there are many special aspects that must be considered for transfusion therapy in neonates. The transfusion risks in neonates include adverse outcomes specific for preterm infants as well as increased metabolic, immunologic, and infectious complications. To reduce the risks of transfusion-transmitted cytomegalovirus infection and transfusion-associated graft-versus-host disease, leukoreduced and irradiated cellular blood products should be used for all neonates. This review summarizes the risks of neonatal transfusion therapy, specific methods to reduce risk, and current trends and practices of red blood cell and platelet transfusions in neonates, to facilitate decision-making for neonatal transfusion.

• Pediatric Infection and Vaccine
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• 제26권1호
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• pp.66-70
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• 2019

신생아의 태반을 통한 사람면역결핍바이러스 감염은 아프리카에서 흔하지만, 대한민국에서는 아직 보고된 적이 없다. 대한민국에서 사람면역결핍바이러스 감염자의 수는 증가하는 추세이며, 특히 생식연령에서의 사람면역결핍바이러스 감염자의 수가 증가하고 있다. 이는 사람면역결핍바이러스 수직 감염의 위험성을 높인다. 저자들은 아직 국내에 보고되지 않은 자궁 내 전파를 통한 신생아의 사람면역결핍바이러스 감염을 경험하였기에 보고하는 바이다. 자궁 내 전파를 통한 사람면역결핍바이러스 감염의 예후는 좋지 않으나 본 증례의 남아는 생후 9개월 경까지 정상 성장과 발달을 보였으며 특별한 의학적 문제가 없었다.