Document Detail


Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units.
MedLine Citation:
PMID:  22633519     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Very-low-birth-weight (VLBW, <1500 g birth weight) infants are at high risk for both early- and late-onset sepsis. Prior studies have observed a predominance of Gram-negative organisms as a cause of early-onset sepsis and Gram-positive organisms as a cause of late-onset sepsis. These reports are limited to large, academic neonatal intensive care units (NICUs) and may not reflect findings in other units. The purpose of this study was to determine the risk factors for sepsis, the causative organisms, and mortality following infection in a large and diverse sample of NICUs.
METHODS: We analysed the results of all cultures obtained from VLBW infants admitted to 313 NICUs from 1997 to 2010.
RESULTS: Over 108,000 VLBW infants were admitted during the study period. Early-onset sepsis occurred in 1032 infants, and late-onset sepsis occurred in 12,204 infants. Gram-negative organisms were the most commonly isolated pathogens in early-onset sepsis, and Gram-positive organisms were most commonly isolated in late-onset sepsis. Early- and late-onset sepsis were associated with increased risk of death controlling for other confounders (odds ratio 1.45 [95% confidence interval [CI] 1.21,1.73], and OR 1.30 [95%CI 1.21, 1.40], respectively).
CONCLUSIONS: This is the largest report of sepsis in VLBW infants to date. Incidence for early-onset sepsis and late-onset sepsis has changed little over this 14-year period, and overall mortality in VLBW infants with early- and late-onset sepsis is higher than in infants with negative cultures.
Authors:
C P Hornik; P Fort; R H Clark; K Watt; D K Benjamin; P B Smith; P Manzoni; E Jacqz-Aigrain; F Kaguelidou; M Cohen-Wolkowiez
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Early human development     Volume:  88 Suppl 2     ISSN:  1872-6232     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-28     Completed Date:  2012-11-29     Revised Date:  2013-06-24    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  S69-74     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Pediatrics, Duke University, Durham, North Carolina 27715, USA.
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MeSH Terms
Descriptor/Qualifier:
Female
Gram-Negative Bacteria / isolation & purification
Gram-Positive Bacteria / isolation & purification
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases* / epidemiology,  microbiology
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal
Male
Risk Factors
Sepsis* / epidemiology,  microbiology,  mortality
Grant Support
ID/Acronym/Agency:
1K23HD060040-01/HD/NICHD NIH HHS; 1K23HD064814-01/HD/NICHD NIH HHS; 1K24HD058735-01/HD/NICHD NIH HHS; 1R01FD003519-01/FD/FDA HHS; 1R01HD057956-02/HD/NICHD NIH HHS; 1U10-HD45962-06/HD/NICHD NIH HHS; DHHS-1R18AE000028-01/AE/ASPE HHS; HHSN267200700051C/HD/NICHD NIH HHS; HHSN267200700051C//PHS HHS; K23 HD060040/HD/NICHD NIH HHS; K23 HD064814/HD/NICHD NIH HHS; K24 HD058735/HD/NICHD NIH HHS; R01 HD057956/HD/NICHD NIH HHS; U10 HD045962/HD/NICHD NIH HHS
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