J Korean Soc Neonatol.  1999 Nov;6(2):186-192.

Change in Granulocyte - Macrophage Colony - Stimulating Factor in Neonatal Infection

Affiliations
  • 1Department of Pediatrics, College of Medicine, Chungnam National University, Taejeon, Korea.

Abstract

PURPOSE: The neuophils contribute as an important defence mechanism against bacterial infection. In neonates with infection, not only the number of neutrophils are decreased due to inhibited production but also phagocytic function is impaired resulting in high mortality rate. The purpose of this study is to establish the effectiveness of exogenous granulocyte-macrophage colony-stimulating factor (GM-CSF) in infected neonates by comparing the serum levels of GM-CSF and various hematologic paratmeters in non-infected and infected neonates.
METHODS
The study included 50 neonates without infection and 23 neonates with infection who were admitted to neonatal intensive care unit of Chungnam National University Hospital in between May 1998 and February 1999. The total number of white blood cell (WBC) counts, absolute granulocyte counts (AGC) and the serum GM-CSF concentration at birth were measured in non-infected neonates and they were stratified according to birth weight and gestational age. The total number of WBC counts, AGC and the serum GM-CSF concentration at postnatal 7th and 14th day were measured and compared with that of infected neonate's. Neonates with infection were divided either to receive exogenous GM-CSF & antibiotics or antibiotics only; The total number of WBC counts, AGC and the serum GM-CSF concentration at post-treatment 2nd and 7th day were measured and compared.
RESULTS
Decreased total number of WBC counts, AGC and the serum GM-CSF concentration at birth were observed with lower birth weight and gestational age. In infected neonates, the total number of WBC counts, AGC and the serum GM-CSF concentration increased more when compared with that of non-infected neonates. Tendency towards increased total number of WBC counts, AGC and the serum GM-CSF concentration were observed after exogenous GM-CSF treatment.
CONCLUSION
We recommend the use of GM-CSF in neonates with infection, especially those without increasing total WBC counts, and absolute granulocyte count as a norrnal physiological response.

Keyword

White blood cell; Granulocyte; Granulocyte-macrophage colony stimulating factor; Neonatal sepsis

MeSH Terms

Anti-Bacterial Agents
Bacterial Infections
Birth Weight
Chungcheongnam-do
Gestational Age
Granulocyte-Macrophage Colony-Stimulating Factor
Granulocytes*
Humans
Infant, Newborn
Intensive Care, Neonatal
Leukocytes
Macrophages*
Mortality
Neutrophils
Parturition
Anti-Bacterial Agents
Granulocyte-Macrophage Colony-Stimulating Factor
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