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This study aimed to compare the results of flow cytometric urine analysis and urine culture for the rapid diagnosis of urinary tract infections and to determine the leukocyte and bacterial cutoffs that could achieve maximum sensitivity and negative predictive value (NPV) during the newborn and infant periods. This cross-sectional observational study included urine samples submitted for culture from the neonatal intensive care unit and outpatient clinic between April 2019 and December 2021. The urine samples were first inoculated for culture and then analyzed for leukocyte and bacterial counts using a flow cytometric method (Sysmex UF-1000i, Kobe, Japan). Maximum sensitivity and NPV values ​​were determined by examining different bacterial and leukocyte cut-offs with Sysmex UF1000i. A total of 138 urine samples from 103 patients were included in the study. The reasons for urine examinations were prolonged hyperbilirubinemia, sepsis, and insufficient weight gain. Although no association was observed with leukocyte count, a bacterial cut-off of 83.4/µL was identified as the optimal threshold. Diagnostic values, including sensitivity (91.6%), specificity (88.6%), NPV (98.5%), and positive predictive value (PPV) (55%), were satisfactory. Based on current data, we suggest that the Sysmex UF-1000i is a valuable screening tool for detecting UTIs in asymptomatic newborns. Integrating this technology into clinical practice could enhance early diagnosis and treatment, ultimately improving neonatal care outcomes.

Background. Mycoplasma hominis is a well-known bacterium colonizing the genito-urinary tract. It may cause pneumonia, bacteremia, abscesses, chronic lung disease, and rarely meningitis during the newborn period. Case. A preterm infant with a birth weight of 885 grams was born at 27 weeks of gestation and had respiratory distress syndrome needing mechanical ventilation. Spontaneous intestinal perforation and grade four intraventricular hemorrhage was diagnosed on day three. Conclusion. M. hominis was accepted as the causative agent of meningitis in this case report.

Background/Objectives: Even with improvements in perinatal care, bronchopulmonary dysplasia (BPD) continues to be a major challenge, especially in smaller and more premature infants. Early detection of severe BPD can improve treatment outcomes. This study aims to evaluate the correlation between the oxygen saturation index (OSI) and severe BPD/death in preterm infants, with a focus on the OSI’s predictive value. Methods: In this retrospective observational study, infants with a gestational age of less than 32 weeks who required either invasive or non-invasive mechanical ventilation were included. Ventilator settings and OSI values were collected on days 3, 7, 14, 21, and 28 of life. The correlations between postnatal OSIs and outcomes such as death or severe BPD were analyzed using logistic regression. Results: Out of the 210 eligible infants, 54 (25.7%) either died or were diagnosed with severe BPD. In our study, OSI values on postnatal days 14, 21, and 28 were significantly higher in preterm infants who developed severe BPD or died, with mean OSI-14, OSI-21, and OSI-28 values of 4.9, 3.5, and 2.8, respectively. The OSI showed the highest sensitivity and specificity on postnatal days 14 and 21, with cut-off points of 3.6 and 3.1, respectively. We built a basic chart to predict severe BPD/death with OSI-14 and OSI-21 and delivery room intubation with 86% sensitivity and 84.5% specificity (increasing up to 98.8% specificity). Conclusions: This study showed that the diagnostic power of the OSI in predicting severe BPD or death was highest for OSI-14 and OSI-21. We demonstrated that calculating the OSI, a non-invasive clinical tool, can predict severe BPD/death in infants born before 32 weeks as early as the 14th day of life.

This study aimed to evaluate the safety of colistin therapy by monitoring renal function and electrolyte levels in critically ill neonates with late‐onset sepsis (LOS) hospitalized in the neonatal intensive care unit (NICU) between 2015 and 2021. This retrospective case–control study included 58 critically ill neonates treated with colistin for late‐onset sepsis and 22 control neonates with late‐onset sepsis who did not receive colistin. Data were analyzed to compare patient outcomes, microbiological profiles, and side effects of treatment. Statistical analyses were performed using repeated‐measures ANOVA and Bayesian calculations to evaluate serum creatinine levels and biochemical parameters over time. Serum creatinine levels showed similar alterations within the first 7 days of colistin treatment with moderate evidence. However, serum magnesium and sodium levels were lower on the 7th day in the colistin‐treated group compared with the control group. Colistin therapy in critically ill neonates with late‐onset sepsis appears to be a viable treatment option with an acceptable short‐term safety profile. These findings emphasize the importance of routine monitoring of renal function and electrolyte levels during colistin use in neonatal intensive care to minimize potential complications.

Background/Objectives: The optimal rate of enteral feeding advancement in preterm infants remains uncertain despite decades of clinical research. This uncertainty arises from concerns that rapid feeding progression may increase the risk of feeding intolerance and necrotizing enterocolitis (NEC), two major causes of morbidity and mortality in this population. The feeding rate may also influence intestinal oxygenation due to mesenteric hemodynamic changes during feeding. This study aimed to evaluate whether the rate of enteral feeding advancement (slow vs. rapid) affects intestinal oxygenation and its association with feeding intolerance (FI) or necrotizing enterocolitis in very low birth weight preterm infants. Methods: This prospective, randomized, two-center study included infants born at 28–32 weeks of gestation. Group 1 received slow advancement (20 mL/kg/day) and Group 2 rapid advancement (30 mL/kg/day) of enteral feeds. Splanchnic (srSO2) and cerebral (crSO2) oxygenation were monitored daily using the FDA-approved INVOS NIRS device during feeding periods (08:00–16:00). Monitoring was performed during minimal enteral nutrition (Phase 1), advancement phases (Phase 2), and for two days after achieving full enteral feeding (Phase 3). The splanchnic-to-cerebral oxygenation ratio (SCOR) was also calculated. Percentage changes in srSO2 and SCOR during and after feeding were calculated from baseline (prefeeding) values and analyzed. Results: Sixty infants were enrolled. Mean gestational age and birth weight were 29.76 ± 1.33 weeks and 1375.05 ± 271.19 g, respectively. Group 2 achieved full enteral feeding significantly earlier (p = 0.001), with no other demographic differences between groups. No cases of NEC were observed. Feeding intolerance occurred in 14 infants (23.3%): 8 in Group 1 and 6 in Group 2 (p = 0.192). Both groups exhibited increased srSO2 and SCOR during feeding; however, the between-group differences were not statistically significant (Phase 2 srSO2 and SCOR: p = 0.07, 0.08; Phase 3 srSO2 and SCOR: p = 0.069, 0.071). However, the percentage change from baseline in srSO2 and SCOR during and after feeding was significantly greater in Group 2 during the advancement and full enteral feeding phases (Phase 2 srSO2 and SCOR: p = 0.03, 0.022; Phase 3 srSO2 and SCOR: p = 0.015, 0.048). Infants with feeding intolerance demonstrated significantly lower srSO2 and SCOR values compared to tolerant infants, and this reduction persisted even after reaching full enteral feeding. ROC analysis suggested gestational age < 30 weeks, birth weight < 1180 g, srSO2 < 52, and SCOR < 0.6 were associated with feeding intolerance. Conclusions: Intermittent bolus feeding increased intestinal oxygenation, with a more pronounced effect in the rapid advancement group. No difference in gastrointestinal adverse outcomes was observed between groups. Lower intestinal oxygenation was associated with feeding intolerance, and the suggested predictive criteria may help guide individualized feeding strategies.

Pneumomediastinum is an uncommon cause of neonatal respiratory distress and occurs in approximately 2.5 per 1000 live births. Although, the most common cause of pneumomediastinum is an underlying lung disease, it can be seen in newborns who undergo resuscitation during delivery without a predisposing factor. Initial diagnosis by chest X-ray can be difficult in some cases. The “spinnaker-sail sign” is an uncommon radiological appearance of pneumomediastinum. Careful conservative management can result with spontaneous resolution without long-term sequelae. In this case report, we present a neonate who developed pneumomediastinum.

Introduction: Metabolic, congenital disorders, and complications seen in infants of diabetic mothers (IDM) are well defined in the literature. We aimed to compare perinatal problems in macrosomic IDM and infants of mothers without diabetes. Methods: We included all macrosomic infants admitted to neonatal intensive care unit (NICU) at two centers between 2017-2020. Birth history, anthropometric measurements, gestational age, metabolic and cardiac problems were compared between macrosomic IDMs and infants of non-DMs. The p-value less than 0.05 was considered statistically significant. Results: 156 (37 IDM, and 119 non-IDM) macrosomic newborns were included in the study. While the incidence of hypoglycemia, need for mechanical ventilation, respiratory distress syndrome, ventricular septal defect (VSD) and persistent pulmonary hypertension (PPH) were statistically similar, the incidence of cesarean section (p=0.002), myocardial hypertrophy (p=0.001), and polycythemia (p=0.019) was higher in the IDM group. While the incidence of respiratory problems and VSD was similar in both groups, myocardial hypertrophy was found in approximately in one fourth (22.2%) of the non-diabetic group. Conclusion: Macrosomic non-IDMs have a similar risk for perinatal-postnatal complications as macrosomic IDMs and should be evaluated accordingly.

Kurşunla karşılaşma endüstrileşen toplumlarda halk sağlığını tehdit eden önemli bir sorundur. Bu konunun boyutları ülkemizde tam olarak belirlenmemekle birlikte, kurşunlu benzinin yaygın kullanımı, bazı su borularının halen kurşun olması, boyaların bir kısmının yapımında kurşunun kullanılması ve boyalardaki kurşun düzeyine ilişkin standartların belirlenmemiş olması, risk faktörlerinin yaygınlığını düşündürmektedir. Şebeke sularında kurşun, belirlenen düzeyin altında 0,02mg/l) bulunurken, havadaki kurşun miktarı ölçülmediğinden, bu yolla olacak bulaşma ortaya konamamaktadır. Bu çalışmada 145 yenidoğanda kordon kanı kurşun düzeyleri ölçülmüş, sosyoekonomik, maternal ve perinatal faktörlerle ilişkisi incelenmiştir. Olgu grubumuzda ortalama kan kurşun düzeyi 8,76 ±5,80 (2-30) !lg/dı olup, vakaların 34'ünde (%23) 10 lg/dı üzerinde, bunların da 15'inde (% 10) 20 lg/dı üzerinde bulunmuştur. Kurşun düzeyi 10 lg/dı üzerinde ve altında olan olgular karşılaştırıldığında, iki grup arasında ortalama gestasyon yaşı, doğum ağırlığı, boyu ve baş çevresi, prematüre doğum ve düşük oranı, cinsiyet, anne yaşı, annenin alkol, sigara kullanımı ve sosyoekonomik sınıflar açısından istatistiksel olarak anlamlı bir fark olmadığı saptanmıştır. Ancak vakaların yaklaşık dörtte birinde kurşunun toksik kabul edilen düzeylerin üzerinde bulunması, bu konuda daha geniş ve çok merkezli çalışmaların başlatılması ve bu olguların nörogelişimsel açıdan takip edilmesinin gerekliliğine işaret etmektedir.