Ronald W. Coen

Studies of bactericidal activity and metabolism of the leukocyte in full-term neonates**

The bactericidal activity of the polymorphonuclear leukocyte has been been found to be decreased in 9 of 25 full-term infants studied within the first 12 hours oflife. This abnormality of leukocyte function occurred despite normal phagocytic activity and was not related to serum factors. An associated finding was failure of normal stimulation of the hexose monophosphate shunt during phagocytosis. These functional and metabolic abnormalities were present, although normal de granulation and normal vacuole formation occurred in the leukocytes.

Bacteremic infection with Pediococcus : Vancomycin-resistant opportunist

Pediococci are recently recognized Gram-positive human pathogens, resistant to vancomycin and generally susceptible to penicillin. Infection in adults has been seen in patients with chronic underlying conditions as well as those with previous abdominal surgery. Two previous infants with congenital gastrointestinal malformations requiring surgical correction have been reported with sepsis attributable to Pediococcus sp. We report a third infant born with gastroschisis who developedPediococcus bacteremia and meningitis 3 months after surgery, and speculate regarding the role of probiotics in the pathogenesis of this infection.

Real time ultrasound diagnosis of hemorrhagic pathological conditions in the posterior fossa of preterm infants.

Real time echoencephalography (RTE) was used to diagnose and serially follow intracranial pathological conditions in the posterior fossa of infants with a gestational age of less than 34 weeks. The posterior fossa was studied in four planes (coronal, modified coronal, sagittal, and parasagittal) with a sector scanner equipped with a high frequency transducer that was placed on the fontanelles and the sutures. Hemorrhagic complications were easily differentiated from normal anatomy. RTE diagnosis was confirmed with computed tomographic scans (5 patients) and postmortem examination of the brain (18 infants). RTE is a precise and noninvasive technique to visualize hemorrhagic and other forms of abnormalities in the infratentorial compartment.

TIMING & INCIDENCE OF INTRAVENTRICULAR-SUBEPENDYMAL HEMORRHAGES (IVH/SEH) IN INBORN PRETERM INFANTS

All 184 inborn infants ≤34 wks GA (mean 30 wks) were examined with ultrasound (US) to study timing, incidence & evolution of IVH/SEH. Incidence by BW: ≤1000 gm, 77%; 1001-1250 gm, 47%; 1251-1500 gm, 47%; 1501-2000 gm, 62%. On day 1 96% (177) had US exams; 60% by 6 hrs. of age. Mean time of initial diagnosis was 12 hrs. & mean time of initial bleeding or extension after day 1 was 64 hrs.Hydrocephalus occurred in 17% and porencephaly occurred in 8% of all infants with IVH/SEH.SEH/IVH was present on 1st day in 103/116 (89%) infants. Nearly half of these infants extended their hemorrhages by day 2 or 3. Only 13 (11%) of the infants without IVH/SEH on day 1 bled on subsequent days. IVH/SEH was observed in 18 of 29 (62%) infants weighing between 1500-2000 gm.