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Prevalence and pathogen distribution of neonatal sepsis among very-low-birth-weight infants.
MedLine Citation:
PMID:  22964280     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Neonatal sepsis contributes to great mortality and morbidity among very-low-birth-weight (VLBW) infants. Prevalence and pathogen distribution of sepsis in the neonatal intensive care units (NICUs) vary with time and geographic location. Such information serves as a guide for selection of empirical antibiotics coverage.
METHODS: This is a case series study performed by retrospective chart review of VLBW infants (birth body weight, BBW, <1500 g) in a medical center during a 5-year period from January 2005 to December 2009. Episodes of positive blood cultures, pathogen distribution and related clinical manifestations were described.
RESULTS: A total of 158 episodes of sepsis were identified from 1042 VLBW infants. Sepsis rate was 152 per 1000 live births. The vast majority of infections (60.7%) were caused by Gram-positive organisms [G(+)], and overall Coagulase-negative staphylococci (CoNS) (52.5%) were the most common pathogen identified. Prevalence for early-onset sepsis (EOS) was 1% and for late-onset sepsis (LOS) was 14.2%. Infants with EOS had a much higher case fatality rate than LOS (40% vs. 4.7%). Escherichia coli (40%) were the leading pathogen of EOS while CoNS (54.7%) was the leading pathogens of LOS. Overall, apnea and/or bradycardia and/or cyanosis (65.8%), poor activity (48.7%), and increased respiratory effort (43.0%) were the most common presenting features of sepsis.
CONCLUSION: Unlike term infants, Gram-negative organism and E coli were the leading pathogen of EOS among VLBW infants. Judicious and timely use of antibiotic therapy is crucial in the care of VLBW infants.
Authors:
Wai Ho Lim; Reyin Lien; Yhu-Chering Huang; Ming-Chou Chiang; Ren-Huei Fu; Shih-Ming Chu; Jen-Fu Hsu; Peng-Hong Yang
Publication Detail:
Type:  Journal Article     Date:  2012-07-23
Journal Detail:
Title:  Pediatrics and neonatology     Volume:  53     ISSN:  1875-9572     ISO Abbreviation:  Pediatr Neonatol     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-09-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101484755     Medline TA:  Pediatr Neonatol     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  228-34     Citation Subset:  IM    
Copyright Information:
Copyright © 2012. Published by Elsevier B.V.
Affiliation:
Division of Neonatology, Chang Gung Children's Hospital, School of Medicine, Chang Gung University, Kweishan, Taoyuan, Taiwan; Division of Pediatric General Medicine, Chang Gung Children's Hospital, School of Medicine, Chang Gung University, Kweishan, Taoyuan, Taiwan.
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