Document Detail


Early sepsis does not increase the risk of late sepsis in very low birth weight neonates.
MedLine Citation:
PMID:  23295144     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine whether preterm very low birth weight (VLBW) infants have an increased risk of late-onset sepsis (LOS) following early-onset sepsis (EOS).
STUDY DESIGN: Retrospective analysis of VLBW infants (401-1500 g) born September 1998 through December 2009 who survived >72 hours and were cared for within the National Institute of Child Health and Human Development Neonatal Research Network. Sepsis was defined by growth of bacteria or fungi in a blood culture obtained ≤ 72 hours of birth (EOS) or >72 hours (LOS) and antimicrobial therapy for ≥ 5 days or death <5 days while receiving therapy. Regression models were used to assess risk of death or LOS by 120 days and LOS by 120 days among survivors to discharge or 120 days, adjusting for gestational age and other covariates.
RESULTS: Of 34,396 infants studied, 504 (1.5%) had EOS. After adjustment, risk of death or LOS by 120 days did not differ overall for infants with EOS compared with those without EOS [risk ratio (RR): 0.99 (0.89-1.09)] but was reduced in infants born at <25 weeks gestation [RR: 0.87 (0.76-0.99), P = .048]. Among survivors, no difference in LOS risk was found overall for infants with versus without EOS [RR: 0.88 (0.75-1.02)], but LOS risk was reduced in infants with birth weight 401-750 g who had EOS [RR: 0.80 (0.64-0.99), P = .047].
CONCLUSIONS: Risk of LOS after EOS was not increased in VLBW infants. Surprisingly, risk of LOS following EOS appeared to be reduced in the smallest, most premature infants, underscoring the need for age-specific analyses of immune function.
Authors:
James L Wynn; Nellie I Hansen; Abhik Das; C Michael Cotten; Ronald N Goldberg; Pablo J Sánchez; Edward F Bell; Krisa P Van Meurs; Waldemar A Carlo; Abbot R Laptook; Rosemary D Higgins; Daniel K Benjamin; Barbara J Stoll;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2013-01-05
Journal Detail:
Title:  The Journal of pediatrics     Volume:  162     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-26     Completed Date:  2013-07-12     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  942-8.e1-3     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Female
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / epidemiology,  microbiology*,  mortality
Infant, Very Low Birth Weight
Male
Retrospective Studies
Risk Factors
Sepsis / epidemiology*,  microbiology,  mortality
Survival Analysis
Grant Support
ID/Acronym/Agency:
1K24HD058735-01/HD/NICHD NIH HHS; 1R01FD003519-01/FD/FDA HHS; 1R01HD057956-02/HD/NICHD NIH HHS; 1U10-HD45962-06/HD/NICHD NIH HHS; 8084//PHS HHS; HHSN267200700051C//PHS HHS; HHSN275201000003I/HD/NICHD NIH HHS; M01 RR125/RR/NCRR NIH HHS; M01 RR16587/RR/NCRR NIH HHS; M01 RR32/RR/NCRR NIH HHS; M01 RR39/RR/NCRR NIH HHS; M01 RR44/RR/NCRR NIH HHS; M01 RR54/RR/NCRR NIH HHS; M01 RR59/RR/NCRR NIH HHS; M01 RR6022/RR/NCRR NIH HHS; M01 RR633/RR/NCRR NIH HHS; M01 RR64/RR/NCRR NIH HHS; M01 RR70/RR/NCRR NIH HHS; M01 RR7122/RR/NCRR NIH HHS; M01 RR750/RR/NCRR NIH HHS; M01 RR80/RR/NCRR NIH HHS; M01 RR997/RR/NCRR NIH HHS; NCRR UL1024160//PHS HHS; U10 HD021364/HD/NICHD NIH HHS; U10 HD21364/HD/NICHD NIH HHS; U10 HD21373/HD/NICHD NIH HHS; U10 HD21385/HD/NICHD NIH HHS; U10 HD21397/HD/NICHD NIH HHS; U10 HD27851/HD/NICHD NIH HHS; U10 HD27853/HD/NICHD NIH HHS; U10 HD27856/HD/NICHD NIH HHS; U10 HD27871/HD/NICHD NIH HHS; U10 HD27880/HD/NICHD NIH HHS; U10 HD27881/HD/NICHD NIH HHS; U10 HD27904/HD/NICHD NIH HHS; U10 HD34216/HD/NICHD NIH HHS; U10 HD36790/HD/NICHD NIH HHS; U10 HD40461/HD/NICHD NIH HHS; U10 HD40492/HD/NICHD NIH HHS; U10 HD40498/HD/NICHD NIH HHS; U10 HD40521/HD/NICHD NIH HHS; U10 HD40689/HD/NICHD NIH HHS; U10 HD53089/HD/NICHD NIH HHS; U10 HD53109/HD/NICHD NIH HHS; U10 HD53119/HD/NICHD NIH HHS; U10 HD53124/HD/NICHD NIH HHS; U10HD21415/HD/NICHD NIH HHS; UL1 RR24139/RR/NCRR NIH HHS; UL1 TR000041/TR/NCATS NIH HHS; UL1 TR000142/TR/NCATS NIH HHS
Investigator
Investigator/Affiliation:
Alan H Jobe / ; Michael S Caplan / ; Yvette Yatchmink / ; Robert Burke / ; Angelita M Hensman / ; Suzy Ventura / ; Michele C Walsh / ; Avroy A Fanaroff / ; Nancy S Newman / ; Kurt Schibler / ; Edward F Donovan / ; Barbara Alexander / ; Kate Bridges / ; Cathy Grisby / ; Marcia Worley Mersmann / ; Holly L Mincey / ; Jody Hessling / ; Kathy J Auten / ; Kimberley A Fisher / ; Katherine A Foy / ; David P Carlton / ; Ellen C Hale / ; Linda L Wright / ; Elizabeth M McClure / ; Stephanie Wilson Archer / ; Brenda B Poindexter / ; James A Lemons / ; Dianne E Herron / ; Lucy C Miller / ; Leslie Dawn Wilson / ; W Kenneth Poole / ; Dennis Wallace / ; Jeanette O'Donnell Auman / ; Margaret Cunningham / ; Betty K Hastings / ; Elizabeth M McClure / ; Carolyn M Petrie Huitema / ; Kristin M Zaterka-Baxter / ; David K Stevenson / ; M Bethany Ball / ; Marian M Adams / ; Ivan D Frantz / ; Brenda L MacKinnon / ; Ellen Nylen / ; Anne Furey / ; Namasivayam Ambalavanan / ; Monica V Collins / ; Shirley S Cosby / ; Neil N Finer / ; Maynard R Rasmussen / ; Paul R Wozniak / ; Kathy Arnell / ; Renee Bridge / ; Clarence Demetrio / ; Wade Rich / ; John A Widness / ; Karen J Johnson / ; Charles R Bauer / ; Shahnaz Duara / ; Ruth Everett-Thomas / ; Amy Mur / ; Worth / ; Kristi L Watterberg / ; Lu-Ann Papile / ; Robin K Ohls / ; Conra Backstrom Lacy / ; Dale L Phelps / ; Ronnie Guillet / ; Linda J Reubens / ; Erica Burnell / ; Mary Rowan / ; Cassandra A Horihan / ; Sheldon B Korones / ; Tina Hudson / ; Charles R Rosenfeld / ; Walid A Salhab / ; Jeannette p Burchfield / ; Alicia Guzman / ; Gaynelle Hensley / ; Melissa H Leps / ; Susie Madison / ; Nancy A Miller / ; Lizette E Torres / ; Jon E Tyson / ; Kathleen A Kennedy / ; Esther G Akpa / ; Patty Ann Orekoya / ; Beverly Foley Harris / ; Claudia I Franco / ; Anna E Lis / ; Sarah Martin / ; Georgia E McDavid / ; Patti L Pierce Tate / ; Maegan C Simmons / ; Roger G Faix / ; Bradley A Yoder / ; Shawna Baker / ; Jill Burnett / ; Jennifer J Jensen / ; Karen A Osborne / ; Kimberlee Weaver-Lewis / ; T Michael O'Shea / ; Nancy J Peters / ; Rebecca Bara / ; Debra Driscoll / ; Geraldine Muran / ; Elizabeth Billian / ; Laura Sumner / ; Kara Sawaya / ; Kathleen Weingarden / ; Richard A Ehrenkranz / ; Harris Jacobs / ; Patricia Cervone / ; Patricia Gettner / ; Monica Konstantino / ; JoAnn Poulsen / ; Janet Taft / ; Joanne Williams /

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