Method of diagnosis of bacterial infections in newborns

The invention relates to medicine, namely to neonatology, and can be used in clinical practice for the early diagnosis of bacterial infections in newborns.

The major problem is neonatology hospital infections that are relevant to all hospitals, but they acquire a special significance for the resuscitation and intensive care for newborns, where the focus patients are particularly susceptible to the appearance of inflammatory complications. In the context of the treatment of the extreme conditions, when antibiotic therapy is one of the leading, timing bacteriological diagnosis can not meet the clinicians.

There are many ways of early diagnosis of bacterial infections (a. A. N 1,291,880; 1,225,578 AS N; Severtsov MK et al. The method of enzyme immunoassay for the detection of antibodies antipseudomonal in individuals vaccinated pioimmunogenom. Zh. Microbiology. 1985, N 1, c. 55-59; Wittenberg VG et al. The vapor phase gas chromatographic analysis in rapid diagnosis of anaerobic infections. Zh. microbiology. 1986, N 1, c. 20-24, etc.), but the methods for early diagnosis of bacterial infections in newborns with ferritin as a diagnostic marker in the available literature, not been discovered.

There is a method of diagnosis of staphylococcal infection in infants (N AS 1,225,578), which is isolated from the blood to the staphylococcus bacteriological method, in order to increase the accuracy of diagnosis, further define the blood circulating immune complexes and their level of judge available, or sepsis stafilokokktsemii transistor.

The disadvantages of the prior art are: 1. A method is specific, ie, It is used to confirm the diagnosis of staphylococcal infection.

2. This method is implemented only when sowing Staphylococcus blood that is long in time. In addition, generalized septic infection in 40% of cases is not confirmed bacteriologically.

These drawbacks are eliminated in the proposed technical solution.

The object of the invention is to accelerate and increase the accuracy of the method of early diagnosis of bacterial infections.

This object is achieved by the fact that the admission to the pediatric patients examined serum ferritin and achieving its level of 700 ng / ml and above are diagnosed sepsis.

Giperferriya serum causes greater susceptibility of patients to bacterial and fungal pathogens. Iron deficiency in the body affects the factors of the humoral and cellular immunity, decreasing the immunological resistance. Ferritin active reserve ferroproteins contained in the cells of all tissues of the body. Although the content of serum ferritin in serum slightly, it correlates well with the richness of depots and separate the breast tissue that has been successfully used for diagnostic purposes.

In our studies, it was observed that patients, especially in neonates receiving mechanical ventilation (ALV), a generalized septic infection accompanied by an increase in serum ferrite more than 1.5 times in comparison with the background (for admission) indicators ( P <0.05). This increase was registered with the 5-6 day stay of children in the room and reaches a maximum of 10-11 day. In the group of children who did not reach the level of ferritin 700 ng / ml in all periods of the survey, there were no clinical signs of systemic infection. As for the 3 groups of newborns admitted to the sepsis, the survey in all periods have maintained high levels of serum ferritin, and only at the time of transfer of children in the somatic department decreased its level (tab. 1).

Detailed description of the method and examples of its particular application.

The method is as follows. When a child in a department of the veins take 0.5 ml of blood and immunometric method using a ceramic set of "Amerlayt Ferritin" determine the level of serum ferritin. If a child ferritin level of 700 ng / ml or higher, then it is diagnosed the development of septic infection. For one study requires 25 l serum. The study takes 20 minutes.

Example 1: The child-in, 5 nights, medical history N 5316. Entered the Department with the diagnosis of perinatal encephalopathy, hemorrhagic syndrome. The level of ferritin 578 ng / ml. Following the etiopathogenetic treatment of the child's condition improved significantly. The level of serum ferritin in all periods of the study did not exceed 600 ng / mL. Transferred to the somatic department for 6 hours. In the subsequent recovery.

Example 2: Child T to 5 days, medical history N 3601. The diagnosis on admission: perinatal encephalopathy, hemorrhagic syndrome. Ferritin levels at admission 406.4 ng / ml. After 5 days, the serum ferritin level was 700 ng / ml. On day 8 the child's condition has deteriorated significantly, there were clinical signs of septic infection. After correction of the treatment the child's condition was stabilized. Transferred to the somatic branch on the 16th day. In the subsequent recovery.

Example 3: A child of M-C, 14 days, medical history N 1606. The diagnosis on admission: perinatal CNS lesions, purulent omphalitis pneumonia. In connection with respiratory failure child transferred to the ventilator. Ferritin levels at admission 991 ng / ml. A child diagnosed with sepsis. The correction treatment. After 5 days, the ferritin level of 854 ng / ml. The child is held hemosorbtion with ultraviolet blood irradiation. On the 26th day of treatment serum ferritin 312 ng / ml. Transferred to the somatic compartment. In the subsequent recovery.

Based on the above, the proposed method compared to the existing offers the following advantages: 1. The method allows for early diagnosis of sepsis before the onset of clinical symptoms; 2. The type of defense is universal; 3. The need for a study of 20 minutes.

4. The process efficiency was 88% (in the prototype method 76%).

The method was tested in the intensive therapy in 82 infants.