Cytokine profiles of preterm neonates with fungal and bacterial sepsis.
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2012-08
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Abstract
BACKGROUND: Information on cytokine profiles in fungal sepsis (FS), an important cause of mortality in extremely low birthweight (ELBW) infants, is lacking. We hypothesized that cytokine profiles in the first 21 d of life in ELBW infants with FS differ from those with bacterial sepsis (BS) or no sepsis (NS). METHODS: In a secondary analysis of the National Institute of Child Health and Human Development Cytokine study, three groups were defined-FS (≥1 episode of FS), BS (≥1 episode of BS without FS), and NS. Association between 11 cytokines assayed in dried blood spots obtained on days 0-1, 3 ± 1, 7 ± 2, 14 ± 3, and 21 ± 3 and sepsis group was explored. RESULTS: Of 1,066 infants, 89 had FS and 368 had BS. As compared with BS, FS was more likely to be associated with lower birthweight, vaginal delivery, patent ductus arteriosus, postnatal steroids, multiple central lines, longer respiratory support and hospital stay, and higher mortality (P < 0.05). Analyses controlling for covariates showed significant group differences over time for interferon-γ (IFN-γ), interleukin (IL)-10, IL-18, transforming growth factor-β (TGF-β), and tumor necrosis factor-α (TNF-α) (P < 0.05). CONCLUSION: Significant differences in profiles for IFN-γ, IL-10, IL-18, TGF-β, and TNF-α in FS, BS, or NS in this hypothesis-generating secondary study require validation in rigorously designed prospective studies and may have implications for diagnosis and treatment.
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Sood, Beena G, Seetha Shankaran, Robert L Schelonka, Shampa Saha, Danny K Benjamin, Pablo J Sánchez, Ira Adams-Chapman, Barbara J Stoll, et al. (2012). Cytokine profiles of preterm neonates with fungal and bacterial sepsis. Pediatr Res, 72(2). pp. 212–220. 10.1038/pr.2012.56 Retrieved from https://hdl.handle.net/10161/13145.
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Daniel Kelly Benjamin
Dr. Danny Benjamin is the Principal Investigator and Chair of the National Institute of Child Health and Human Development’s Pediatric Trials Network. The Network is responsible for designing and leading clinical trials of off-patent medicines in children of all ages across all therapeutic areas. The team has established, or is actively studying, the correct dosing and safety of more than 70 of the most commonly used medicines in children. Each of these trials is conducted under an Investigational New Drug (IND) application with guidance from the Food and Drug Administration for labeling.
The Pediatric Trials Network has directly impacted the healthcare of over 90% of American children.
Signature programs of the Network include clinical trials in premature, term infants, breast feeding mothers, and obese children. Over the past 10 years, Danny’s group has enrolled more premature infants, at more sites, in more clinical trials of off-patent anti-infectives under an IND than all other academic medical centers, pharmaceutical companies, and government agencies in the world, combined.
Danny is recognized by the National Institutes of Health as a premiere mentor and educator. His research program serves as a platform to train students and early career investigators. Danny’s group has a clinical research summer program for high school and college students that has a focus on trainees under-represented in medicine, and he is the primary mentor for medical students, residents, subspecialty fellows, and multiple junior faculty. He has been the primary or secondary mentor for 10 faculty who have received career development awards and who have then gone on to secure their own funding.
Danny's service to the community is expressed through his passion for coaching baseball. He has coached over 500 recreation league, travel league, and scholastic baseball games and he is the head coach of Smith Middle School, the 5-year reigning southern conference champions. Danny and his wife own a charitable non-profit that provides athletic and fitness opportunities for disadvantaged school-aged boys and girls.
Ronald Norman Goldberg
1. Perinatal asphyxia and neuroprotection - use of umbilical cord blood transfusion
2. Persistent Pulmonary hypertension - use of ethyl nitrite
3. The extremely low-birth-weight infant.
4. Newborn screening - use of digital microfluidics
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