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December 1988, Vol 142, No. 12 >
Article | December 1988

IgM-Enriched Intravenous Immunoglobulin Therapy in Neonatal Sepsis FREE

Khalid N. Haque, FRCP(Ed), FRCPI, FAAP, DCH, DTM&H; Muzamil H. Zaidi, BSc, MBBS; Hasan Bahakim, MD, FAAP
[+] Author Affiliations

Accepted for publication Aug 23, 1988.

Reprint requests to the Department of Paediatrics, College of Medicine, PO Box 2925, Riyadh 11461, Saudi Arabia (Professor Haque).


Am J Dis Child. 1988;142(12):1293-1296. doi:10.1001/archpedi.1988.02150120047038.
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References
Comments

• Despite the development of newer generation of antibiotics, mortality from neonatal sepsis remains high. In a prospective, randomized study, we investigated the use of IgM-enriched immunoglobulin therapy in neonatal sepsis. Two groups of 30 infants each (matched for gestational age, sex, weight, and other variables) were randomly allocated to receive either antibiotics alone (control group) or antibiotics plus 5 mL/kg/d for four days of IgM-enriched immunoglobulin intravenously (immunotherapy group). Mortality from sepsis in the control group was 20% (6/30), while in the immunotherapy group it was 3.3%(1/30). We conclude that IgM-enriched immunoglobulin therapy in conjunction with antibiotic therapy significantly reduces mortality from neonatal sepsis.

(AJDC 1988;142:1293-1296)

REFERENCES

1 +
Sidiropoulos D, Bhome U, von Muralt G, et al:  Immunoglobulin substitution in the treatment of neonatal sepsis . Schweiz Med Wochenschr 1981;;111:1649-1655.
2 +
Oto A:  Major bacterial infections in a referral neonatal intensive care unit . J Infect 1982;;5:117-126.
3 +
Omene JA:  Neonatal septicemia in Benin City, Nigeria . Trop Geogr Med 1979;;31:35-39.
4 +
Ohlsson A, Serenius F:  Neonatal septicemia in Riyadh, Saudi Arabia . Acta Paediatr Scand 1981;;70:825-829.
5 +
ElRifai MR:  A study of 214 neonates with infection in Maternity and Children's Hospital, Riyadh, Saudi Arabia . Ann Trop Paediatr 1982;;3:119-122.
6 +
Freedman RM, Ingram DL, Gross I, et al:  A half century of neonatal sepsis at Yale . AJDC 1981;;135:140-144.
7 +
Yoder MC, Polin RA:  Immunotherapy of neonatal septicemia . Pediatr Clin North Am 1986;;33:481-501.
8 +
Lindquist L, Lundberg P, Massing R:  Pepsin treated human gamma-globulin in bacterial infection . Vox Sang 1981;;40:329-338.
9 +
Conway SP, Gillies DRN, Docherty A, et al:  The effect of weekly intramuscular gamma-globulin on infection-related morbidity and mortality in the premature baby . Paediatr Rev Commun 1987;;1:277-289.
10 +
Haque KN, Zaidi MH, Haque SK, et al:  Intravenous immunoglobulin for prevention of sepsis in preterm and low birth weight infants . Pediatr Infect Dis J 1986;;5:622-625.
11 +
Klein JO, Dashefsky B, Norton CR:  Selection of antimicrobial agents for the treatment of neonatal sepsis . Rev Infect Dis 1983;;5( (suppl 1) ): S55-S64.
12 +
McCraken GH Jr:  Bacterial and viral infections in the newborn , in Avery GB (ed): Neonatology, Pathophysiology and Management of the Newborn , ed 2. Philadelphia, JB Lippincott, 1983;, p 723.
13 +
Alving BM, Finlayson JS: Characteristics and Uses of Intravenous Preparations . US Dept of Health and Human Services publication 80-9005. Washington, DC, US Government Printing Office, 1980;.
14 +
Baker CJ, Edwards MS, Kasper DL:  Role of antibody to native type 111 polysaccharide of group B streptococcus in infant infection . Pediatrics 1981;;68:544-549.
15 +
Hemming VG, Hall RT, Rhodes PG, et al:  Assessment of group B streptococcal opsonins in human and rabbit serum by neutrophil chemiluminescence . J Clin Invest 1976;;58:1379-1387.
16 +
Vogel LC, Kretschmer RR, Padnos DM, et al:  Protective value of gammaglobulin preparations against group B streptococcal infections in chick embryos and mice . Pediatr Res 1980;;14:788-792.
17 +
Wasserman RL:  Intravenous gammaglobulin prophylaxsis for newborn infants . Pediatr Infect Dis 1986;;5:620-621.
18 +
Steen JA:  Gammaglobulin in preventing infections in premature infants . Arch Pediatr 1960;;77:291-294.
19 +
Amer J, Olt E, Ibbolt FA, et al:  The effect of monthly gammaglobulin administration on morbidity and mortality from infection in premature infants during first year of life . Pediatrics 1963;;32:4-9.
20 +
Fisher GW, Weisman LB, Hemming VG, et al:  Intravenous immunoglobulin in neonatal group B streptococcal disease . Am J Med S 1984;;76( (suppl) ):117-123.
21 +
Van Furth R, Schuit HRE, Hijmans W:  The immunological development of the human fetus . J Exp Med 1965;;122:1173-1188.
22 +
Urquhart GED:  Serum IgM and IgA responses in influenza A infections . J Clin Pathol 1974;;27:198-201.
23 +
Stubner G:  Indirect evidence of cell wall alterations in Pseudomonas aeruginosa by immunoglobulin preparations . Infection 1984;;12: 223-224.
24 +
Just HM, Metzger M, Vogel W, et al: Therapeutic effects of immunoglobulins in ICU patients with severe infection, abstract S1-05. Abstracts of the 18th Congress of the International Society of Blood Transfusion, Munich, July 22-27. Basel, Switzerland, Karger-Verlag, 1984.
25 +
Christensen KK, Christensen P, Bucher HU, et al:  Intravenous administration of human IgG to newborn infants: Changes in serum antibody levels to group B streptococci . Eur J Pediatr 1984;;143:123-127.
26 +
Christensen KK, Christensen P, Duc G, et al:  Human IgG antibodies to carbohydrate and protein antigens in mouse protection tests with group B streptococci . Pediatr Res 1984;;18:478-482.
27 +
Chirico G, Rondini G, Plebani A, et al:  Intravenous gammaglobulin therapy for prophylaxis of infection in high-risk neonates . J Pediatr 1987;;110:437-442.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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References

1 +
Sidiropoulos D, Bhome U, von Muralt G, et al:  Immunoglobulin substitution in the treatment of neonatal sepsis . Schweiz Med Wochenschr 1981;;111:1649-1655.
2 +
Oto A:  Major bacterial infections in a referral neonatal intensive care unit . J Infect 1982;;5:117-126.
3 +
Omene JA:  Neonatal septicemia in Benin City, Nigeria . Trop Geogr Med 1979;;31:35-39.
4 +
Ohlsson A, Serenius F:  Neonatal septicemia in Riyadh, Saudi Arabia . Acta Paediatr Scand 1981;;70:825-829.
5 +
ElRifai MR:  A study of 214 neonates with infection in Maternity and Children's Hospital, Riyadh, Saudi Arabia . Ann Trop Paediatr 1982;;3:119-122.
6 +
Freedman RM, Ingram DL, Gross I, et al:  A half century of neonatal sepsis at Yale . AJDC 1981;;135:140-144.
7 +
Yoder MC, Polin RA:  Immunotherapy of neonatal septicemia . Pediatr Clin North Am 1986;;33:481-501.
8 +
Lindquist L, Lundberg P, Massing R:  Pepsin treated human gamma-globulin in bacterial infection . Vox Sang 1981;;40:329-338.
9 +
Conway SP, Gillies DRN, Docherty A, et al:  The effect of weekly intramuscular gamma-globulin on infection-related morbidity and mortality in the premature baby . Paediatr Rev Commun 1987;;1:277-289.
10 +
Haque KN, Zaidi MH, Haque SK, et al:  Intravenous immunoglobulin for prevention of sepsis in preterm and low birth weight infants . Pediatr Infect Dis J 1986;;5:622-625.
11 +
Klein JO, Dashefsky B, Norton CR:  Selection of antimicrobial agents for the treatment of neonatal sepsis . Rev Infect Dis 1983;;5( (suppl 1) ): S55-S64.
12 +
McCraken GH Jr:  Bacterial and viral infections in the newborn , in Avery GB (ed): Neonatology, Pathophysiology and Management of the Newborn , ed 2. Philadelphia, JB Lippincott, 1983;, p 723.
13 +
Alving BM, Finlayson JS: Characteristics and Uses of Intravenous Preparations . US Dept of Health and Human Services publication 80-9005. Washington, DC, US Government Printing Office, 1980;.
14 +
Baker CJ, Edwards MS, Kasper DL:  Role of antibody to native type 111 polysaccharide of group B streptococcus in infant infection . Pediatrics 1981;;68:544-549.
15 +
Hemming VG, Hall RT, Rhodes PG, et al:  Assessment of group B streptococcal opsonins in human and rabbit serum by neutrophil chemiluminescence . J Clin Invest 1976;;58:1379-1387.
16 +
Vogel LC, Kretschmer RR, Padnos DM, et al:  Protective value of gammaglobulin preparations against group B streptococcal infections in chick embryos and mice . Pediatr Res 1980;;14:788-792.
17 +
Wasserman RL:  Intravenous gammaglobulin prophylaxsis for newborn infants . Pediatr Infect Dis 1986;;5:620-621.
18 +
Steen JA:  Gammaglobulin in preventing infections in premature infants . Arch Pediatr 1960;;77:291-294.
19 +
Amer J, Olt E, Ibbolt FA, et al:  The effect of monthly gammaglobulin administration on morbidity and mortality from infection in premature infants during first year of life . Pediatrics 1963;;32:4-9.
20 +
Fisher GW, Weisman LB, Hemming VG, et al:  Intravenous immunoglobulin in neonatal group B streptococcal disease . Am J Med S 1984;;76( (suppl) ):117-123.
21 +
Van Furth R, Schuit HRE, Hijmans W:  The immunological development of the human fetus . J Exp Med 1965;;122:1173-1188.
22 +
Urquhart GED:  Serum IgM and IgA responses in influenza A infections . J Clin Pathol 1974;;27:198-201.
23 +
Stubner G:  Indirect evidence of cell wall alterations in Pseudomonas aeruginosa by immunoglobulin preparations . Infection 1984;;12: 223-224.
24 +
Just HM, Metzger M, Vogel W, et al: Therapeutic effects of immunoglobulins in ICU patients with severe infection, abstract S1-05. Abstracts of the 18th Congress of the International Society of Blood Transfusion, Munich, July 22-27. Basel, Switzerland, Karger-Verlag, 1984.
25 +
Christensen KK, Christensen P, Bucher HU, et al:  Intravenous administration of human IgG to newborn infants: Changes in serum antibody levels to group B streptococci . Eur J Pediatr 1984;;143:123-127.
26 +
Christensen KK, Christensen P, Duc G, et al:  Human IgG antibodies to carbohydrate and protein antigens in mouse protection tests with group B streptococci . Pediatr Res 1984;;18:478-482.
27 +
Chirico G, Rondini G, Plebani A, et al:  Intravenous gammaglobulin therapy for prophylaxis of infection in high-risk neonates . J Pediatr 1987;;110:437-442.

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