G-CSF May Improve Outcome Attributable To Neonatal Sepsis Complicated By Neutropenia And The Mechanism Associate With Cykotine

Objective:To investigate pathogens,clinical characteristic and risk factors of neonatallate-onset sepsis．Methods: A retrospective review of cases with late-onset sepsis from January2009toAugust2011was conducted.151cases were selected based on the clinical presentationand at least one positive result of blood culture as sepsis group,the302infants,hospitalized at the same time without sepsis were in the control group.The pathogensdistribution clinical characteristic and risk factors were analyzed．Results: The major pathogens of the infections included gram positive bacteria(48.34%),especially coagulase negative staphyloccus (40.40%),and gram negativebacteria (45.03%),as well as fungus(6.62%).LONS infants had various clinicalmanifestations, including temperature abnormity,feeding intolerance,low response etal.Logistic regression analysis showed that the main risk facors included gestationage<37weeks,birth weight<2500g, use of ventilator and PICC,P<0.05.Conclusions：Coagulase negative staphyloccus are the major pathogens for neonatallate-onset sepsis. Ggestation age<37weeks,birth weight<2500g, use of ventilator andPICC are the main risk factors of culture positive late-onset sepsis. objective:To determine whether adjunctive therapy with recombinant humangranulocyte colony-stimulating factor(rhG-CSF) could improve the outcome ofsepsis-associated neonatal neutropenia compared with conventional therapy and toexplore its mechanism.Method： We undertook a prospective randomized study between May2011toFebruary2012,54neonates meet the sepsis clinical diagnostic criteria and is associatedwith neutropenia syndrome of preterm infants were randomized to receiverhG-CSF,10μg/kg/d,for3days or standard management. The course of antibiotics,continuous time of jaundice,duration of ventilator days,duration of oxygentherapy,blood culture-positive cases of conversion time,complications,hospitalinfection rate,incidence of side effects and the white blood cell count,absoluteneutrophil count,high sensitivity C-reactive protein,cytokines IL-6,G-CSF,and neonatalillness severity score were accessed before and after treatment. And to investigate themechanism of the adjuvant treatment of sepsis complicated by neutropenia inpremature infant.Result：1. G-CSF may improve anti-infectious effect and lower the incidencecomplications.No significant differences exited in the course of antibiotics, duration ofventilator days,duration of oxygen therapy between G-CSF group and control group（P>0.05）.2. The white blood cell count and absolute neutrophil count in G-CSF group weresiginificant increased compared with control group.3.The IL-6level decreased significantly after G-CSF treatment on day3,and the G-CSF level were increased in the G-CSF group （P=0.002）.The two cytotine areassociated with the effect of G-CSF.Conclusion: The white blood cell countafter trial entry rose significantly inG-CSF group. Adjunctive therapy with G-CSF can improve anti-infectious effect,lowerthe incidence of complications and have no significant side effect.Cytotine IL-6、G-CSF are associated with the effect of G-CSF.