Background: Neonatal sepsis is one of the most important causes for elevated morbidity and mor-tality rates in neonatal intensive care units worldwide. While the clinical manifestations of a neo-natal sepsis tend to be nonspecific, its rapid development and life-threatening potential calls for reliable markers for early detection. Methods: We conducted a retrospective single center study including all neonates suspected of having developed a neonatal sepsis within 2013 - 2016. Perinatal and clinical characteristics, as well as microbiological and laboratory findings were evaluated. Neonatal sepsis was either defined as culture proven sepsis (positive blood culture) or clinical sepsis (at least one symptom and elevated C-reative protein (CRP) concentrations within 72h with nega-tive blood culture). We further differentiated between early-onset (EOS) and late-onset (LOS) sepsis. Results: Microbiological colonisation screening frequently did not detect the organism which sub-sequently caused the sepsis. Depending on the age of the newborn with sepsis (EOS or LOS), as-sociations between different anamnestic and clinical factors (prenatal or postnatal ones) were found. Especially the central-peripheral temperature difference showed a strong association to LOS. Laboratory results useful for the early detection of a neonatal sepsis included interleukin-6 (IL-6) and CRP concentrations. Conclusion: Elevated IL-6 >100 ng/l was a strong marker for neonatal sepsis. When choosing the antibiotics for treatment, data from microbiological colonisation screening should be considered, but not solely relied on. Some indicators for infection depended also on postnatal age.:Einführung 1
Definition 1
Sepsis 1
Pathophysiologie der Sepsis 2
Early-onset Sepsis vs. Late-onset Sepsis 4
Klinik und Diagnostik 6
AWMF-Leitlinie „Bakterielle Infektionen bei Neugeborenen“ 10
Mikrobiologisches Kolonisationsscreening 14
Aufgabenstellung und Zielsetzung 16
Patient:innen und Methoden 18
Datenerhebung 18
Gruppenbildung 20
Statistische Analyse 22
Ergebnisse 23
Early-onset Sepsis mit mikrobiologischem Nachweis 23
Early-onset Sepsis mit nur paraklinischem Nachweis 30
Late-onset Sepsis mit mikrobiologischem Nachweis 36
Late-onset Sepsis mit nur paraklinischem Nachweis 44
Diskussion 50
Art der Erreger in Leipzig 50
Mikrobiologisches Kolonisationsscreening 51
Anamnestische und klinische Risikofaktoren 55
Laborchemische Faktoren 60
Aussagekraft der Blutkultur 69
Grenzen der Studie 71
Weiterer Ausblick 72
Zusammenfassung 75
Literaturverzeichnis 78
Abkürzungsverzeichnis 83
Tabellenverzeichnis 85
Abbildungsverzeichnis 86
Erklärung über die eigenständige Abfassung der Arbeit 88
Curriculum vitae 89
Danksagung 91
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:90656 |
| Date | 26 March 2024 |
| Creators | Cao, Isabel |
| Contributors | Universität Leipzig |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | German |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:doctoralThesis, info:eu-repo/semantics/doctoralThesis, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
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