Intravenous immunoglobulin for prophylaxis of nosocomial sepsis
A total of 76 premature newborn infants with gestational age of 34 weeks or less were enrolled in a randomized controlled study to determine whether intravenously administrated immunoglobulin (IVIG) is able to prevent nosocomial sepsis. Forty infants were given 0.5 g/kg IVIG on the first day of life and 36 infants with similar gestational age and birth weight were selected as controls and did not receive IVIG. The frequency of proven sepsis, with a positive blood and/or cerebrospinal fluid culture, was significantly lower in infants who received IVIG as compared to controls (42.5vs 80.0%) (p<0.01). The mortality rate attributable to infection was not different in IVIG recipients and in controls (41vs 48%) (p>0.05). The overall mortality rates in the two groups were not different either (35.0vs 44.4%) (p>0.05). The majority of micro-organisms isolated from the blood culture of the patients were gram negative microorganisms (Klebsiella, Enterobacter). IVIG therapy was believed to be effective for prophylaxis of nosocomial infection, but such therapy was not able to reduce overall mortality rate or mortality rate due to systemic infection in prematurely born infants in our intensive care unit where the causative pathogens are usually gram negative microorganisms.
Key wordsIVIG Neonatal sepsis Nosocomial infection
Eriksson M. Neonatal septicemia.Acta Paediatr Scand
1933; 72: 1–8.CrossRefGoogle Scholar
Satar M, Atici A, Yilmaz M. Nosocomial infections in the neonatal unit of Cukurova medical faculty.Cukurova Univ Tip Fak Der
1993; 18: 294–298.Google Scholar
Satar M, Atici A, Savas Net al.
The etiology of neonatal sepsis.Ann Med Sci
1994; 3: 12–15.Google Scholar
Bhutta ZA, Naqvi SH, Muzaffar Tet al
Neonatal sepsis in Pakistan: presentations and pathogens.Acta Paediatr Scand
1991; 80: 596–601.PubMedCrossRefGoogle Scholar
Stabile A, Sopo SM, Romanelli Vet al.
Intravenous immunoglobulin for prophylaxis of neonatal sepsis in premature infants.Arch Dis Child
1988; 63: 441–443.PubMedGoogle Scholar
Ballow M, Fang F, Good RAet al.
Developmental aspects of complement components in the newborn.Clin Exp Immunol
1974; 18: 257–266.PubMedGoogle Scholar
Hill HR, Augustine NH, Jaffe HS. Human recombinant interferon gamma enhances neonatal PMN activation and movement and increases free intracellular calcium.J Exp Med
1991; 173: 767–770.PubMedCrossRefGoogle Scholar
Haque KN, Zaidi MH, Haque SKet al.
Intravenous immunoglobulin for prevention of sepsis in preterm and low birth weight infants.Pediatr Infect Dis
1986; 5: 622–625.PubMedGoogle Scholar
Chirico G, Rondini G, Plebani Aet al.
Intravenous gammaglobulin therapy for prophylaxis of infection in high-risk neonates.J Pediatr
1987; 110: 437–442.PubMedCrossRefGoogle Scholar
Kinney J, Mundorf L, Gleason C. Efficacy and pharmacokinetics of intravenous immune globulin administration to high-risk neonates.Am J Dis Child
1991; 145: 1233–1238.PubMedGoogle Scholar
Magny JF, Bremard-Oury C, Brault D. Intravenous immunoglobulin-therapy for prevention of infection in highrisk premature infants: report of a multicenter, double-blind study.Pediatrics
1991; 88: 437–443.PubMedGoogle Scholar
Fanaroff AA, Korones SB, Wright LLet al.
A controlled trial of intravenous immune globulin to reduce nosocomial infections in very-low-birth-weight infants.N Engl J Med
1994; 330: 1107–1113.PubMedCrossRefGoogle Scholar
Farr V, Mitchell RG, Neligan GA. The definition of some external characteristics used in the assessment of gestational age in the newborn infant.Develop Med Clin Neurol
1966; 8: 507–511.Google Scholar
Hill HR. Intravenous immunoglobulin use in the neonate: role in prophylaxis and therapy of infection.Pediatr Infect Dis J
1993; 12: 549–559.PubMedCrossRefGoogle Scholar
Baker CJ, Melish ME, Hall RTet al.
Givner LB and the Multicenter Group for the study of immune globulin in Neonates. Intravenous immune globulin for the prevention of nosocomial infection in low-birth-weight neonates.N Engl J Med
1992; 327: 213–219.PubMedGoogle Scholar
Conway SP, Ng PC, Howel Det al.
Prophylactic intravenous immunoglobulin in pre-term infants: a controlled trial.Vox Sang
1990; 59: 6–11.PubMedCrossRefGoogle Scholar
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