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Effects of bacterial sepsis on protein metabolism in infants during the first week
Insights
Neonatal bacterial infections rapidly induce a catabolic state, marked by hyperaminoacidemia and increased nitrogen loss. Early antibiotic treatment (within 8 hours) is crucial to prevent severe metabolic disturbances in infants.
Area of Science:
- Biochemistry
- Neonatal Medicine
- Infectious Diseases
Background:
- Bacterial infections in newborns can rapidly lead to a catabolic state.
- Metabolic alterations in neonates differ significantly from those in older individuals.
Purpose of the Study:
- To investigate the metabolic changes associated with bacterial infections in the first week of life.
- To determine the impact of treatment timing on metabolic disturbances.
Main Methods:
- Analysis of serum and urine for amino acid and urea concentrations.
- Monitoring of renal nitrogen losses.
- Correlation of metabolic changes with clinical course and treatment delay.
Main Results:
- Key metabolic changes include hyperaminoacidemia, hyperaminoaciduria, elevated serum urea, and increased renal nitrogen losses.
- Metabolic disturbances worsen significantly if antibiotic treatment is delayed beyond 8 hours from symptom onset.
- No correlation was found between specific bacterial species and the metabolic response.
Conclusions:
- Bacterial infections in early life trigger rapid and severe metabolic disturbances, primarily affecting cell metabolism.
- Timely antibiotic intervention is critical to mitigate these metabolic imbalances.
- Nutritional management should prioritize adequate energy intake, with protein intake limited to prevent exacerbating metabolic issues.
Abstract:
In the presence of bacterial infection during the first week of life a catabolic state evolves more rapidly than in the later life. Hyperaminoacidaemia and subsequent hyperaminoaciduria, elevated urea concentrations in serum, and increased renal nitrogen losses are the most important metabolic changes. These findings correlate with the clinical course of the disease and refer to the primary disturbance of cell metabolism as the cause of the metabolic changes observed. While no relation could be observed between metabolic response and bacterial species, there is a significant dependence on the time interval from the occurrence of first clinical symptoms at the beginning of antibiotic treatment. If this period is longer than 8 h, serious metabolic disturbances will usually be found. Due to the limited amino acids utilization, especially by the liver, an adequate energy intake should be the primary aim of nutrition, whereas a protein intake of more than 2.0 to 2.5 g/kg X day may further aggravate the metabolic imbalance.