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Risk Factors and Outcomes of Late-Onset Bacterial Sepsis in Preterm Neonates Born at < 32 Weeks' Gestation.
MedLine Citation:
PMID:  25486288     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective This study aims to identify the incidence, risk factors, and outcomes of late-onset sepsis in preterm neonates in Canadian neonatal intensive care units (NICUs). Study Design This retrospective analysis included preterm infants born at < 32 weeks' gestation and admitted to 29 NICUs in the Canadian Neonatal Network during the years 2010 and 2011. Infants were classified into three groups: no infection, gram-positive infection, and gram-negative infection. Late-onset sepsis was defined as positive blood and/or spinal fluid cultures after 3 days of birth. Risk factors and the primary outcome of mortality or bronchopulmonary dysplasia (BPD) were compared between the groups. Results Out of the 7,509 neonates, 6,405 (85%) had no infection, 909 (12%) had gram-positive, and 195 (3%) had gram-negative infections. Lower gestation, higher Score for Neonatal Acute Physiology, version II scores, the presence of central catheters for > 4 days, parenteral nutrition for > 7 days, and prolonged duration of nothing by mouth were associated with late-onset sepsis. After controlling for confounders, the odds ratio (OR) of mortality/BPD were higher in infants who had gram-negative (OR 2.79, 95% confidence interval [CI] 1.96-3.97) and gram-positive (OR 1.44, 95% CI 1.21-1.71) sepsis as compared with no infection. Conclusions Bacterial late-onset sepsis in very preterm neonates was associated with mortality and BPD. Neonates with gram-negative sepsis had the highest risk of adverse outcomes as compared with gram-positive sepsis or no sepsis.
Authors:
Jyotsna Shah; Ann L Jefferies; Eugene W Yoon; Shoo K Lee; Prakesh S Shah;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-12-8
Journal Detail:
Title:  American journal of perinatology     Volume:  -     ISSN:  1098-8785     ISO Abbreviation:  Am J Perinatol     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-8     Completed Date:  -     Revised Date:  2014-12-9    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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