Incidence and causes of sepsis in glucose-6-phosphate dehydrogenase-deficient newborn infants.
To determine the susceptibility to sepsis in newborn infants deficient in glucose-6-phosphate dehydrogenase (G6PD), we screened 33,943 Saudi Arab infants. Deficiency of G6PD was found in 18%. Sepsis was determined by the presence of clinical signs of sepsis and confirmed by positive blood cultures. Sepsis was documented in 75 infants (2.2/1000). The incidence of sepsis was significantly higher in 6138 G6PD-deficient infants (3.4/1000) than in the 27,805 with normal G6PD activity (1.9/1000; p less than 0.02). The incidence of catalase-positive organism sepsis was higher in G6PD-deficient infants (2.9/1000) compared with those with normal G6PD activity (1/1000; p less than 0.0002), whereas the incidence of catalase-negative organism sepsis did not differ (p less than 0.2). Deficiency of G6PD was more common in infants with late sepsis (46%) than in those with early sepsis (21%) and in all infants screened (18%) (p less than 0.03 and p less than 0.001, respectively). We conclude that neonates with G6PD deficiency are more susceptible to late sepsis and to infection with catalase-positive organisms. The exact mechanism for the increased susceptibility is not clear, but a partial explanation could be lack of leukocyte bactericidal activity associated with G6PD deficiency, and an increased susceptibility to infection caused by hyperferremia resulting from lysis of G6PD-deficient erythrocytes.
Abu-Osba
Y K
YK
Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Mallouh
A A
AA
Hann
R W
RW
D001419:Bacteria / Q000201:enzymology; D001424:Bacterial Infections; D002374:Catalase; D004198:Disease Susceptibility; D005260:Female; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012307:Risk Factors; D012529:Saudi Arabia; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology
D002374:Catalase