title: Systemic responses of preterm newborns with presumed or documented bacteraemia.
abstract: OBJECTIVE
  To compare the frequency of elevated concentrations of inflammation-related proteins in the blood of infants born before the 28th week of gestation who had documented bacteraemia and those who had presumed (antibiotic-treated but culture-negative) bacteraemia to those who had neither.
  
  
  METHODS
  The subjects of this study are the 868 infants born at 14 institutions for whom information about protein measurements on at least two of the three protocol days (days 1, 7, and 14) was available and who did not have Bell stage 3 necrotizing enterocolitis or isolated bowel perforation, which were strongly associated with bacteraemia in this sample.
  
  
  RESULTS
  Newborns with presumed early (week 1) bacteraemia had elevated concentrations of only a few inflammation-related proteins, while those who had presumed late (weeks 2-4) bacteraemia did not have any elevations. In contrast, newborns who had documented early bacteraemia had a moderately strong signal, while those who had documented late bacteraemia had a stronger signal with more protein concentrations elevated on two separate occasions a week apart.
  
  
  CONCLUSIONS
  Culture-confirmed early and late bacteraemia are accompanied/followed by systemic inflammatory responses not seen with presumed early and late bacteraemia.
authors.affiliation: Department of Neurology, Children's Hospital Boston, and Harvard Medical School, Boston, MA 02215-5349, USA. alan.leviton@childrens.harvard.edu
authors.forename: Alan
authors.initials: A
authors.lastname: Leviton
authors.forename: T Michael
authors.initials: TM
authors.lastname: O'Shea
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Bednarek
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Allred
authors.forename: Raina N
authors.initials: RN
authors.lastname: Fichorova
authors.forename: Olaf
authors.initials: O
authors.lastname: Dammann
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy; D046508:Culture Techniques; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy; D013997:Time Factors
chemical_list: D000209:Acute-Phase Proteins; D000900:Anti-Bacterial Agents
references.citation: AJNR Am J Neuroradiol. 2003 May;24(5):805-9
references.pmid: 12748075
references.citation: Arch Dis Child Fetal Neonatal Ed. 2005 May;90(3):F220-4
references.pmid: 15846011
references.citation: Pediatrics. 2008 Aug;122(2):299-305
references.pmid: 18676547
references.citation: Curr Clin Pharmacol. 2006 Jan;1(1):1-4
references.pmid: 18666373
references.citation: Early Hum Dev. 2009 Nov;85(11):719-25
references.pmid: 19765918
references.citation: Clin Perinatol. 2010 Sep;37(3):599-610
references.pmid: 20813273
references.citation: BMJ. 1998 Apr 18;316(7139):1236-8
references.pmid: 9553006
references.citation: Am J Obstet Gynecol. 2011 May;204(5):418.e1-418.e12
references.pmid: 21349490
references.citation: J Neurol Sci. 1973 Jan;18(1):53-66
references.pmid: 4690638
references.citation: J Pediatr. 2010 Nov;157(5):751-6.e1
references.pmid: 20598317
references.citation: Epidemiology. 1990 Jan;1(1):43-6
references.pmid: 2081237
references.citation: Pediatrics. 2009 May;123(5):1314-9
references.pmid: 19403497
references.citation: J Pediatr. 2011 Jun;158(6):897-903.e1-5
references.pmid: 21238986
references.citation: mBio. 2011 Jan 18;2(1):e00280-10
references.pmid: 21264056
references.citation: Nature. 2005 Oct 13;437(7061):1032-7
references.pmid: 16136080
references.citation: Acta Paediatr. 2011 Jan;100(1):7-8
references.pmid: 20722634
references.citation: Cytokine. 2011 Feb;53(2):249-55
references.pmid: 21145756
references.citation: BMC Med Res Methodol. 2002 Jun 17;2:8
references.pmid: 12069695
references.citation: Infect Immun. 2006 Oct;74(10):5773-9
references.pmid: 16988255
references.citation: Am J Epidemiol. 1991 Sep 15;134(6):604-13
references.pmid: 1951265
references.citation: Pediatr Res. 2011 Apr;69(4):347-53
references.pmid: 21150694
references.citation: Pediatrics. 2002 Aug;110(2 Pt 1):285-91
references.pmid: 12165580
references.citation: Acta Paediatr. 2011 Jan;100(1):36-41
references.pmid: 20712830
references.citation: Pediatr Infect Dis J. 2009 Dec;28(12):1052-6
references.pmid: 19953725
references.citation: Am J Epidemiol. 1976 Dec;104(6):621-6
references.pmid: 998609
references.citation: J Pediatr. 1996 Jul;129(1):72-80
references.pmid: 8757565
references.citation: Pediatr Res. 2011 Jan;69(1):68-73
references.pmid: 20921924
references.citation: Early Hum Dev. 2011 May;87(5):325-30
references.pmid: 21334149
references.citation: Acta Paediatr. 2004 Feb;93(2):211-5
references.pmid: 15046276
references.citation: Cytokine. 2011 Jan;53(1):66-73
references.pmid: 20934883
references.citation: Pediatrics. 2007 Sep;120(3):e604-9
references.pmid: 17698966
references.citation: Curr Opin Infect Dis. 2008 Jun;21(3):223-7
references.pmid: 18448965
references.citation: Anal Chem. 2008 Jun 15;80(12):4741-51
references.pmid: 18484740
references.citation: Clin Perinatol. 2010 Jun;37(2):421-38
references.pmid: 20569816
references.citation: J Clin Epidemiol. 2001 Apr;54(4):343-9
references.pmid: 11297884
references.citation: JAMA. 2004 Nov 17;292(19):2357-65
references.pmid: 15547163